Forms

Below are some of the forms you will need throughout your journey with us. Please print and review required forms (marked with an asterisk *) before your first appointment.

Also below are patients’ contracts and consent agreements describing the importance of vitamin supplementation, smoking cessation prior to surgery, and understanding of pregnancy and fertility issues associated with bariatric surgery.

For your convenience, all forms related to dietician preoperative evaluations, teaching, preoperative liquid protein diet guidelines and postoperative support can be found under the “Forms” section at The GI & Bariatric Nutrition Center on www.Nutrition5.com by Nancy Lum, RD, LDN, our bariatric surgical dietician.

Information regarding pre-operative psychological evaluation for bariatric surgery and postoperative behavioral therapy is run by Dawn O’Meally, LCSW-C.

Bariatric Surgery:

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Ascension Saint Agnes

For more than 150 years, Ascension Saint Agnes Hospital has been dedicated to the art of healing by providing exceptional care to the greater Baltimore area. Built on a strong foundation of excellent medical care and compassion, Ascension Saint Agnes is committed to providing the best care for our patients for many years to come.

MBSAQIP Accredited Center Quality Program
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St. Agnes Bariatric Surgery Blue Distinction
Bariatrics 20th Anniversary

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