Get Bariatricpsychevaluations

The Bariatricpsychevaluations form is an essential document for individuals seeking psychological evaluations related to bariatric surgery. This guide provides a step-by-step approach to successfully completing the form online, ensuring all necessary information is accurately provided.

Follow the steps to complete the Bariatricpsychevaluations form.

1. Press the ‘Get Form’ button to access the Bariatricpsychevaluations form and open it in your preferred editor.
2. Begin by entering the today’s date at the top of the form. This is essential for proper documentation.
3. Fill in the name of the referring surgeon or clinic. If unsure, indicate ‘Not Sure’.
4. Proceed to the patient information section. Provide your last name, first name, and middle initial as requested.
5. Complete your address details including city, state, and zip code.
6. Enter your home and cell phone numbers, indicating whether voicemails or texts can be received.
7. Supply your email address and select your gender from the options provided.
8. Input your birthdate and age, followed by your marital status by selecting the appropriate option.
9. If applicable, fill in the insurance information. Provide details about your primary and secondary insurance, including the relationship to the subscriber.
10. Review and complete the informed patient consent section. Ensure you understand all terms regarding financial responsibility.
11. Sign and date the patient/guardian signature section to confirm the accuracy of the information provided.
12. Next, complete the Wahler Physical Symptoms Inventory by circling the appropriate frequency for each symptom listed.
13. Continue to the PAS Response Form, circling the correct answer for each statement regarding your feelings and health.
14. Finally, review the symptoms checklist and check any items that are true or relevant to you.
15. Once you have filled out all sections, save your changes. You can also download, print, or share the completed form as needed.

Complete the Bariatricpsychevaluations form online today and take the next step towards your health journey.