Bariatric Surgery | Forms


Provided in this section are several necessary documents that are necessary in order for The Crawford Clinic to provide you with the best bariatric care possible.

Form 1:  History and Physical Sheet

This form is long, but necessary.  It goes into deep detail with regards to your overall medical history.  It does focus on the medical conditions you suffer from that are a result of being obese.  It also helps the physicians at The Crawford Clinic help the patient determine which bariatric procedure is right for them.  By completing this form, you also fulfill one of the many requirements of your insurance company to cover this procedure.

 Form 2:  Physician Supervised Diet Forms

A requirement for some insurances is a physician supervised diet.  This information can sometimes be obtained from your primary medical doctors notes from your regular weight loss visits.  In order to provide physicians who are not familiar with the information required, we have created these sheets which can streamline your approval process.  Completion of these sheets is nota requirement but may make it easier on your physician to provide you with the necessary information to help you with a smooth approval process.

Form 3: Post Operative Instuctions– Band or Sleeve

The type of operation you undergo determines what is normal and abnormal with regards to your post operative care. The Crawford Clinic has provided you with detailed instructions as to what to expect with each individual operation.  Whether its a Sleeve Gastrectomy or Lap Band, the success of the operation is knowing what to expect.  These sheets should not only clarify your journey after the operation,but they will help you identify small and well as large bumps in the road.  It also instuctis you on how handle these bumps.