To help you navigate the pre-operative process for your bariatric surgery, it is important to meet with physician specialists and other members of the Crozer bariatrics surgery support team. Feel free to print out the form below to track your physician appointments. If you prefer, you may print out the PDF of this form by clicking on the link below.
Pre-operative Check List (PDF)
Back to Bariatrics Surgery home page.
Specialty |
Physician Name |
Date of Appointment |
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Cardiology |
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Gastroenterology |
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Nutrition |
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Primary Care |
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Pre-Operative Testing |
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Pulmonary Medicine |
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Chest X-ray |
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Labs |
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Sleep Study (if indicated) |
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Ultrasound of Abdomen (if indicated) |
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Upper Gastrointestinal Swallow |
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Upper Endoscopy |
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Venous Duplex of Lower Extremities |
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Support Group: