Weight Loss Surgery Newsletter

Southwest Bariatric Surgeons will soon distribute an e-mail newsletter with useful information, tips, and resources for people who have had weight loss surgery and those who are considering it. If you’d like to receive our newsletter, please complete the form below.

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How did you hear about this Web site?	Choose I’m a patient. Friend/relative Physician Search engine Another Web site Newspaper ad Radio ad TV ad Called office Other
Are you a patient of Southwest Bariatric Surgeons?	Choose yes no
Have you had weight loss surgery?	Choose yes no
If yes, which Procedure?	Choose Lap-Band Gastric Bypass Gastric Sleeve Other
If no, are you considering having weight loss surgery?	Choose yes no
If yes, which procedure?	Choose Lap-Band Gastric Bypass Gastric Sleeve Unsure Other
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