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Weight Loss Surgery in Yucatan

ESPANOL  

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All information submitted is privileged and confidential. We do not share or distribute this information with third parties and it's strictly used for medical purposes This form has the soul purpose of learning the basic information to determine if you qualify for a weight loss procedure. There is no cost or obligation and you will receive an email with information about the procedure, our available packages and pricing as well as date availability.

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Your information

Body mass index

Obesity Related Problems
Obesity
Diabetes
Hypertension
Bone Problems
Depression
Sleep Disorders
Physical Condition
Digestive System
Heart and Circulatory System
Respiratory Problems
Compulsive Eating
Isolation
Gastro Esophageal Reflux
Hiatal Hernia
Smoke
Drink Alcohol
Use Drugs
Use of accessories such as: pacemakers, CPAP, removable dentures, etc.
Drug allergy
Previuos surgeries
Previuos abdominal surgeries?
Are you in treatment?
Aditional data
Preferred Surgery Date
How Did You Find Us?
Select Your Surgery