Step 1 of 714%Name First Last Email* Phone*About PatientAre you a smoker?*NoYesAre you willing to quit smoking for weight loss?YesNoMaybe, but I'll need helpAre you pregnant?*NoYes To complete this step. Please watch the video until the end.The Sleeve Gastrectomy works to help with weight loss by which of the following methods? Bypassing sections of absorption of the digestive tract Portion control Decreasing the amount to circulating hunger hormones Restricting the bad foods you eatPlease select all that applyINCORRECT. The gastric sleeve does not reroute any parts of the stomach. Please revise your selections.INCORRECT. Sleeve Gastrectomy surgery will not help you restrict the bad foods you eat. Please revise your selections.CORRECT! Please click next below and watch the next video. To complete this step. Please watch the video until the end.Height Feet*Height inches*Total Height (inches)WeightBMI result: To complete this step. Please watch the video until the end.Select all the ways to qualify for bariatric surgery* Select All You must be at least 18 years old Have a BMI higher than 40 Have a BMI of at least 35 with other obesity-related health issuesSelect all that applyCORRECT! Please click next below and watch the next video. To complete this step. Please watch the video until the end.True or false? Weight loss surgery is the easy way to lose weight and I don’t have to follow prescribed diets and exercise to be successful.*TrueFalseINCORRECT - You will not receive weight loss surgery without fully committing to our weight loss plan.CORRECT - Everyone's weight loss journey is different. We provide amazing support from our whole time. When you commit to this new lifestyle, we are right there with you! Please click next below and watch the next video. To complete this step. Please watch the video until the end.True or false? Regular follow up with your doctor is not necessary after the first 30 days after bariatric surgery.*TrueFalseINCORRECT - We need to follow up with you multiple times after the surgery to make sure that their were no complications so that you can continue your healthier lifestyle.CORRECT - We are committed to your successful weight loss journey. We need to monitor your progress and make sure there are no complications with your stomach. Please click next below and watch the next video. To complete this step. Please watch the video until the end.The gastric sleeve surgery, like any surgery, has inherent risks associated with it, and should not be taken lightly. Some of the risks are:* Select All Leakage Risk of reoperation Vomiting CORRECT - There is a potential for stomach leakage at the site of the staples, however, the gastric sleeve has reduced this complication significantly. Please click next below. CORRECT - With any surgery, there is a small chance of reoperation. The gastric sleeve has the lowest percentage of reoperation than all other bariatric surgeries. Please click next below. CORRECT - Surgery may cause nausea & vomiting however, this is not common. Please call us immediately. Please click next below.Additional Questions?Please let us know if we can answer any additional questions.CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms. Weight Loss Seminar"The Weight is Over!"