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  • Usc Metabolic And Bariatric Surgery Program Bariatric Patient Questionnaire 2018

Get Usc Metabolic And Bariatric Surgery Program Bariatric Patient Questionnaire 2018-2025

Ire This questionnaire is required. Please complete and bring it with you on your first appointment. Name: Birthdate: / / Date: Address: Home phone: Cell: Work: Email: Marital Status: Ethnicity: Single Married Divorced African American Arabic Asian Choose not to specify Other Separated Partnered Caucasian Hispanic Widowed Native American Insurance Information: Name of Insurance: HMO PPO Member ID Number: Insurance Phone number (Located in back of card): Primary Subscribers.

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To be eligible for bariatric surgery, you must be between 16 and 70 years of age (with some exceptions) and morbidly obese (weighing at least 100 pounds over your ideal body weight and having a BMI of 40).

Bariatric surgery is for all patients with a very high weight who need weight loss surgery. Metabolic surgery is used with the specific intent to address diabetes and metabolic dysfunctions that have failed to respond to lifestyle and medication changes as opposed to obesity per se.

Weight loss surgery is also known as bariatric and metabolic surgery. These terms are used in order to reflect the impact of these operations on patients' weight and the health of their metabolism (breakdown of food into energy).

Certain basic tests are done prior to bariatric surgery: a Complete Blood Count (CBC), Urinalysis, and a Chemistry Panel, which gives a readout of about 20 blood chemistry values. All patients get a chest X-ray and an electrocardiogram. Many surgeons ask for a gallbladder ultrasound to look for gallstones.

Oral glucose tolerance test (OGTT) remains the mainstay to diagnose GDM 3. This is not useful amongst those who have undergone bariatric surgery because they had alteration of bowel anatomy and physiology 4. These leads to altered gastro-intestinal transit time and thereby higher risk of dumping syndrome.

Contraindications to Weight Loss Surgery You have an inflammatory disease or condition of the gastrointestinal tract, such as ulcers, severe esophagitis, or Crohns disease. You have severe heart or lung disease that makes you a poor candidate for any surgery.

Sleeve Gastrectomy Improves Glycemia Independent of Weight Loss by Restoring Hepatic Sensitivity.

Women with a history of sleeve gastrectomy may not be able to undertake the oral glucose tolerance test, due to the risk of dumping syndrome.

There is no set weight that you have to be to qualify for gastric sleeve surgery or any of the other bariatric surgery procedures. However, your doctor will want to see that you have attempted to lose weight through diet and exercise and are having trouble losing weight on your own.

Insurance approval: Once you've completed all required medical tests, we send necessary documentation to your insurance company for preauthorization. This approval process can take a few weeks to a few months, depending on your insurance company.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232