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Are You a Candidate for Weight Loss Surgery?
Take our 60 Second Assessment to Find Out.
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I am...
Male
Female
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Do you struggle to maintain a healthy weight using only diet and exercise?
Yes
No
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Do you suffer from any of these common health issues?
Select all that apply. Then select "Next."
Heartburn / Acid Reflux
High Blood Pressure
Sleep Apnea
Diabetes
Joint/Bone Issues
None
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Hidden: Convert Height to Total Inches
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Hidden: BMI Calculator
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MWL
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WLS
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MWL or WLS
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What is your height and weight?
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Enter your height and weight below.
Weight (lbs)
Height (ft)
Height (in)
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What is your biggest challenge or question right now?
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Select one from below.
Can I afford it?
Which solution is right for me?
Will I keep the weight off long-term?
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Which payment option describes you best?
Select one from below.
Self-Pay / Financing
Private Insurance
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17
Have you decided which treatment is right for you?
Select one from below. If you are not sure yet, that is perfectly fine. Just select "Not Sure Yet"
Not Sure
Bariatric Surgery
Medical Weight Loss
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Have you decided which surgical option is right for you?
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Gastric Sleeve
Gastric Bypass
Duodenal Switch
SADI-S
Not Sure
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Have you decided which medical weight loss is right for you
Select one from below. If you are not sure yet, that is perfectly fine. Just select "Not Sure Yet"
Medication for Weight Loss
STAR Coaching
Not Sure
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20
Where are you in your Weight Loss Surgery decision process?
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Step 1. Researching
Step 2. Evaluating Treatments
Step 3. Choosing my Doctor
Step 4. Ready to Book a Consult
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Thanks! Enter your information below to receive your Personalized Results
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You will also receive an Email Course about your weight loss options from Nashville Weight Loss Solutions. We keep your information safe and private. This Assessment is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. By providing your contact information you agree to receive calls, texts, and emails from Nashville Weight Loss Solutions.
First Name
Last Name
Email
Phone
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Email
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Phone
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First Name
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Last Name
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Assessment - Date of Submission
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Date
Month
Day
Year
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