Southern Oregon Bariatric Center

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Register for an online seminar

The information below is collected to help provide you with the most up-to-date information and care available to you. Upon completion of this form, you will be taken to our Online Seminar. The seminar will last for approximately 45 minutes, and will contain 6 quiz sections. You must pass all 6 sections with a minimum of 80% to schedule your consultation. When you complete the online seminar, you will have the opportunity to contact our office to take the next step. We understand how important your privacy is, and we will not use this information to distribute to outside parties.

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Patient Information

Date of Birth *

Height * feet inches

Weight * pounds

First Name *

Last Name *

Gender *

Contact Information

Address 1 *

Address 2

City *

State *

Zip *

Country

Primary Phone *

Alternate Phone

E-mail Address *

Others

Insurance *

At Southern Oregon Bariatric Center we offer several programs to meet the needs of our community and the surrounding areas.

Southern Oregon Bariatric Center offers a selection of surgical solutions to meet the needs of our patients. These include Adjustable Gastric Banding Procedure in patient and outpatient, Open Roux-en-Y Gastric Bypass and Laparoscopic Roux-en-Y Gastric Bypass.