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For Office Use Only Date Received BMI Division of Minimally Invasive Bariatric and General Surgery Anita Corollas, MD Giselle Haman, MD Carol McCloskey, MD Ramesh Samantha, MD INITIAL EVALUATION FORM
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What is bariatric surgery evaluation form?
Bariatric surgery evaluation form is a document used to assess a patient's readiness for bariatric surgery.
Who is required to file bariatric surgery evaluation form?
Patients who are considering undergoing bariatric surgery are required to file the evaluation form.
How to fill out bariatric surgery evaluation form?
The form must be filled out by the patient and their healthcare provider, detailing medical history, current health status, and reasons for pursuing bariatric surgery.
What is the purpose of bariatric surgery evaluation form?
The purpose of the evaluation form is to ensure that the patient is a suitable candidate for bariatric surgery and to assess potential risks.
What information must be reported on bariatric surgery evaluation form?
Information such as medical history, current medications, previous weight loss attempts, and psychological well-being must be reported on the form.
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