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Pre-Operative Check List

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.

Pre-operative Check List (PDF)

Specialty

Physician Name

Date of Appointment

 

Cardiology

  

  

 

Gastroenterology

  

  

 

Nutrition

  

  

 

Primary Care

  

  

Pre-Operative Testing

  

  

 

Pulmonary Medicine

  

  

 

Chest X-ray

  

  

 

Labs

  

  

 

Sleep Study (if indicated)

  

  

 

Ultrasound of Abdomen (if indicated)

  

  

 

Upper Gastrointestinal Swallow

  

  

 

Upper Endoscopy

  

  

 

Venous Duplex of Lower Extremities