(516) 259-2525
Practice Policy Update Regarding Covid-19

Bariatric Questionnaire

Bariatric Questionnaire

1. Have you thoroughly explored other treatments for obesity?
2. How much weight do you want to lose?
3. What's Your Body Mass Index
(Calculate your BMI)
4. Do you have any weight-related health issues
(diabetes, hypertension, sleep apnea, joint problems, etc)?
Email

Form submitted successfully!

Thank you for submitting your information.

You qualify for Medical Weight Loss, the Orbera gastric balloon, the Gastric Bypass, or the Sleeve Gastrectomy.

Please contact us at (516) 400-4509 to schedule your consultation. We look forward to helping you and providing excellent care.

Form submitted successfully!

Thank you for submitting your information.

You qualify for Medical Weight Loss, the Orbera gastric balloon, the Gastric Bypass, or the Sleeve Gastrectomy if you have a condition related to Obesity (high blood pressure, diabetes, sleep apnea, etc.).

Please contact us at (516) 400-4509 to schedule your consultation. We look forward to helping you and providing excellent care.

Form submitted successfully!

Thank you for submitting your information.

You qualify for Medical Weight Loss and the Orbera gastric balloon.

Please contact us at (516) 400-4509 to schedule your consultation. We look forward to helping you and providing excellent care.

Form submitted successfully!

Thank you for submitting your information.

You qualify for our Medical Weight Loss program. Please click here to learn more.

Please contact us at (516) 400-4509 to schedule your consultation. We look forward to helping you and providing excellent care.

  • HOME
  • PATIENT PORTAL
  • MEDIA
  • BLOG
  • ESPAÑOL

    • Quick Links

    Contact Information

    Huntington Station Location 33 Walt Whitman Rd., Suite 300B, Huntington Station, NY
    Rockville Centre Location Ryan Medical Arts Building, 2000 N Village Avenue, Suite 310, Rockville Centre, NY 11570
    © 2021 - Clarity Surgical and Weight Loss Solutions - All Rights Reserved.
    Accessibility Statement - Privacy Statement - Sitemap
    Powered by Roya