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Check All That Apply*
- I have not had weight loss surgery before
- I am generally healthy, have occasional heartburn and have not had a heart attack, stroke or kidney failure
- I am 50 pounds overweight or have a BMI between 30-55
- I can walk 200 feet without chest pain or shortness of breath and I am a non-smoker
- I have commercial insurance coverage
- I've researched weight loss surgery and believe bariatric surgery is right for me!
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