Get Initial Consultation Form - Surgicallyslim

Completing the Initial Consultation Form for SurgicallySlim is an essential step in your journey towards surgical weight loss. This guide provides detailed and user-friendly instructions on how to accurately fill out each section of the form, ensuring you communicate your medical history effectively.

Follow the steps to successfully complete your form.

1. Press the ‘Get Form’ button to access the Initial Consultation Form and open it in your preferred editor.
2. Begin by providing your personal information at the top of the form, including your name. This helps to identify your submission.
3. In Section 1, enter details about your primary care doctor, including their name, address, and phone number. Be sure to indicate how you learned about the SurgicallySlim program.
4. For Section 2, check off any symptoms you have experienced. This may include digestive system issues and general health concerns. If none apply, select 'None of the above' as appropriate.
5. In Section 3, review your past medical history and check any relevant conditions or indicate 'None of the above' if this applies.
6. Section 4 requires you to assess your family's medical history. Check the boxes for any conditions that are prevalent in your family.
7. Complete Section 5 by providing information about your social habits, including smoking and alcohol consumption.
8. List your medications in Section 6, including the drug name, dosage, and frequency.
9. In Section 7, note any past surgical history, including weight loss or notable surgeries, while mentioning any drug or food allergies you have.
10. For Section 8, indicate any dietary restrictions you must adhere to. If there are specific restrictions not listed, use the space provided to describe them.
11. Section 9 focuses on your weight loss history. Complete this by sharing your height, weight, and length of time you have been experiencing overweight challenges.
12. Finally, review all the information you have provided for accuracy. Once satisfied, you can save changes, download, print, or share the completed form.

Complete your Initial Consultation Form online today to take the first step towards your weight loss goals.