Patient Forms

Prior to your first visit to Southern Oregon Bariatric Center, we ask that you please fill out the following patient registration forms:

Patient Registration Forms

If you do not have a printer, please fill out the online forms and we will provide you with the other forms at your first visit.

Completing these forms prior to your visit allows sufficient time to finish the more detailed sections. If you have questions, just bring the forms with you and we will help you during your first office visit.

When you have finished the forms, you may:

  • Fax them to 541-245-4813 OR
  • Mail them into our office OR
  • Bring them to any one of our Bariatric Seminars

For your initial office visit please arrive 15 minutes early if you have all forms completed, if not, we need you here a full 30 minutes before your appointment to allow enough time to complete the remaining registration process.

What to Bring

To ensure we can process your paperwork and insurance authorizations as smoothly as possible please bring following to your appointment:

  • Your insurance card.
  • Any physician referrals you may have received from your primary care provider.
  • Picture I.D.
  • Co-payment. We accept cash, checks, and Visa, Mastercard, and Discover credit cards.
  • Your completed forms: Patient Information Form, Medication List and Provider List (PDFs)

Southern Oregon Bariatric Center
Oregon Surgical Specialists, PC
537 Murphy Road, Suite A
Medford, OR 97504

FAX: 541-245-4813

Once received, we will call to schedule an appointment to review this documentation with you and get you started on your path to surgery!

Your transformation starts here.

Call (541) 930-7819. Your transformation starts here.