New Patient Forms
Before your first appointment, we ask you to complete a New Patient Health Analysis form. You can complete the form online or print out a PDF version that you can mail or fax to us.
If you are interested in our surgical weight loss options:
Please attend our in-person seminar or complete the online bariatric seminar before completing the New Patient Health Analysis form. After you complete the seminar and submit the form, we will call you to schedule an appointment with one of our bariatric surgeons.
If you are interested in the non-surgical weight loss options:
Please complete and submit both the New Patient Health Analysis form and the 3-Day Daily Food Diary form. We will then call you to schedule an appointment.
Below are PDF versions if you would prefer to complete paper copies:
Please mail or fax the paper forms to us before your first appointment:
Healthy Weight Management and Bariatric Surgery
Lancaster General Health
2150 Harrisburg Pike, Suite 300
Lancaster, PA 17601