Download our forms

Please download your required documents and please complete them before your visit to St. Louis Bariatric Specialists. Should you have any question regarding our forms, please call us at 314-965-8410 and we will be glad to assist in any way.

Click the form you would like to download!

  1. Print all of our forms.
  2. Insurance Verification Request
  3. Medical History Form
  4. Pre-op Testing Requirements
  5. Release of Information
  6. Dietary History
  7. PCP referral form
  8. Arbitration Agreement
  9. Lap-Band Post Op Instructions
  10. Administrative/ Program Fee Document
  11. Demographic Form
  12. HIPPA Form
  13. Credit Card Form
  14. How did you Discover Us Question
  15. Surgery Clearance Form