IB Bari sx patient info and HQ Form

IB Bari sx patient info and HQ CHECK

Does this cover you for bariatric surgery?

Are you considering using a superannuation to fund your surgery?

Do you smoke or vape?

If yes, how many per day?

Do you drink alcohol?

How many glasses a day/week?

Current Weight

kg

Current Height

cm

Do you have a specific weight-loss goal in mind?

kg

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