Forms
Here, you will find forms you will need throughout your journey with us, whether you are interested in weight loss procedures or gastroenterology. Forms are grouped by Bariatric Surgery, Reflux/Hiatal Hernia surgery and General surgery procedures. Print and review required forms (marked with an asterisk *) before your first appointment.
If you're thinking about weight loss surgery in Maryland, or need a gastroenterology specialist, you can schedule an appointment online, or call us at 410-368-8725.
You can look through the informed consent documents for different surgical procedures outlining all known risks of surgery, most of which our patients have never experienced. Nevertheless, that information is useful in making your decision. Also included are patients' contracts and consent agreements describing the importance of vitamin supplementation, smoking cessation prior to surgery, and understanding of pregnancy and fertility issues associated with bariatric surgery.
For your convenience, all forms related to dietician pre-operative evaluations, teaching, pre-operative liquid protein diet guidelines and post-operative support can be found under the "Forms" section at The GI & Bariatric Nutrition Center by Nancy Lum, RD, LDN, our bariatric surgical dietician.
Information regarding pre-operative psychological evaluation for bariatric surgery and post-operative behavioral therapy can be found at bariatricpsychservices.com run by Dawn O'Meally, LCSW-C.
Informed Consent for Laparoscopic Gastric Bypass
* New Patients Information Letter
*New Bariatric Patient Medical Form
* Bariatric Patient Pre-appointment Checklist
* Requirements for Psychological Clearance
Patients Contract: Vitamins and Protein Supplements
Patients Contract: Smoking Cessation
Patients Contact: Understanding Pregnancy, Fertility and weight loss surgery
Preoperative Supervised Weight Loss Program