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NEW PATIENT REGISTRATIONFORM VENICE METABOLIC AND BARIATRIC SURGERY LAST NAMEFIRST NAMEMIDDLEPREFERRED NAMEADDRESSCITY, STATE, ZIPMAILINGADDRRESS(IF DIFFERENT FROM ABOVE)CITY, STATE, EMAIL ADDRESS HOME
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How to fill out venice metabolic and bariatric

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To fill out Venice Metabolic and Bariatric form, follow these steps:
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Start by entering your personal information such as name, date of birth, gender, and contact details.
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Provide your medical history including any previous surgeries, current medications, and relevant medical conditions.
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Fill in your insurance details, if applicable, including the name of your insurance provider and policy number.
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Answer the questionnaire regarding your weight history, diet and exercise habits, and any previous weight loss attempts.
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Complete the sections related to your psychological evaluation and mental health history.
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Provide information about your support system and the availability of a support network to assist you during the weight loss journey.
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Review the form for accuracy and completeness before submitting it.
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Once you have filled out the form, submit it to the designated authority or healthcare provider as instructed.

Who needs venice metabolic and bariatric?

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Venice Metabolic and Bariatric is typically needed by individuals who:
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- Have a body mass index (BMI) of 40 or more, or a BMI of 35 or more with obesity-related health conditions.
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- Have unsuccessfully tried other weight loss methods such as dieting and exercise.
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- Are committed to making long-term lifestyle changes to improve their overall health.
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- Are physically and psychologically prepared to undergo a surgical weight loss procedure.
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- Have received a recommendation for metabolic and bariatric surgery from a qualified healthcare professional.

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