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Information Video Quiz

Please fill out the following quiz after watching the Bariatric Information Video to determine whether you qualify for a Bariatric Surgery Application Packet. Packet will be sent within five business days.

All fields are required.

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First Name: *
Last Name: *
E-mail: *
Daytime Phone (including area code): *
Which of the following statements are true about morbid obesity? *
Which of the following statements are true about morbid obesity?
Which of the following statements are true about morbid obesity?
Which of the following statements are true about morbid obesity?
Types of weight loss surgery include restrictive, malabsorptive and combination. *
Types of weight loss surgery include restrictive, malabsorptive and combination.
Types of weight loss surgery include restrictive, malabsorptive and combination.
Three contributing factors to the development of obesity are genetics, behavior and environmental issues. *
Three contributing factors to the development of obesity are genetics, behavior and environmental issues.
Three contributing factors to the development of obesity are genetics, behavior and environmental issues.
Obesity is associated with multiple life threatening medical conditions. *
Obesity is associated with multiple life threatening medical conditions.
Obesity is associated with multiple life threatening medical conditions.
Life-long commitment and ongoing communication with the bariatric team is vitally important for successful outcomes. *
Life-long commitment and ongoing communication with the bariatric team is vitally important for successful outcomes.
Life-long commitment and ongoing communication with the bariatric team is vitally important for successful outcomes.
Gastric Bypass surgery is an example of what type of weight loss surgery? *
Gastric Bypass surgery is an example of what type of weight loss surgery?
Gastric Bypass surgery is an example of what type of weight loss surgery?
Gastric Bypass surgery is an example of what type of weight loss surgery?
Lap Band surgery is an example of what type of weight loss surgery? *
Lap Band surgery is an example of what type of weight loss surgery?
Lap Band surgery is an example of what type of weight loss surgery?
Lap Band surgery is an example of what type of weight loss surgery?
Sleeve Gastrectomy surgery is an example of what type of weight loss surgery? *
Sleeve Gastrectomy surgery is an example of what type of weight loss surgery?
Sleeve Gastrectomy surgery is an example of what type of weight loss surgery?
Sleeve Gastrectomy surgery is an example of what type of weight loss surgery?
Health risks of obesity may include: *
Health risks of obesity may include:
Health risks of obesity may include:
Health risks of obesity may include:
We have a multidisciplinary Comprehensive Bariatric Program. *
We have a multidisciplinary Comprehensive Bariatric Program.
We have a multidisciplinary Comprehensive Bariatric Program.
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