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Bariatric Patient Checklist

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Visit 1

Weight BMI

Visit 2

Weight BMI

Visit 3

Weight BMI

Visit 4

Weight BMI

Visit 5

Weight BMI

Visit 6

Weight BMI

Pre-Operative Checklis

Upper GI Xray

Upper Endoscopy

Psychology Clearance

Sleep Study (If Doctor Requests)

Support Group #1

Support Group #2

Support Group #3

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1041 East Yorba Linda Blvd

Suite 306

Placentia, CA 92886

900 South Main Street

Suite 109

Corona, CA 92882

Phone: (657) 216-6090

Fax: (657) 214-3563

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