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Weight Loss Surgery

Bariatric Program Application

Bariatric program applications are available on the link below. You will find instructions on how to mail or fax the completed form to the surgeon of your choice. Once received, you will be considered for a consultation appointment or a referral for related pre-surgery work up. If you are unable to print a copy, or have additional questions, please contact 541-706-4970.

Click here for the bariatric program application.