Feedback Form
Thank you for letting us be a part of your bariatric surgery journey. Sharing your story is a great testimony to those considering weight loss journey. We look forward to hearing about your experience!
Name
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First Name
Last Name
Who Was Your Physician?
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When was your surgery date?
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How many pounds have you lost so far?
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Which are you interested in (you can select more than 1)?
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Filming a short testimonial (we do the filming)
Sharing a Before/After
Being a model for office filming projects
Briefly describe your previous weight loss attempts and how/why you decided to have surgery
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How has your life/health/mobility/relationship improved since surgery?
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What advice would you give to someone who is considering surgery?
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What has been your greatest non-scale victory?
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E-mail
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example@example.com
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