Start your medical review | Bariatric Mexico

Before you start

Have your details ready.

Your medical history and current medications
Any previous surgery and relevant records
Your procedure, destination and timing preferences

Your next step

Share your details with the team.

Please enable JavaScript in your browser to complete this form.

Name *

First

Last

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Choose Procedure *

Choose Procedure

Choose Surgery Destination City: *

City

Choose Surgeon: *

Select Surgeon

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Email 📩 *

Phone 📞 *

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We know you can get busy through out the day. Can we correspond through cellphone text for your convenience?

Send text *

Medical History

Measuring in Imperial or metric

Imperial
metric

Layout

Height In *

Enter Height

Height CM *

Enter Height 1.65

Weight, Lb *

Enter Weight

Weight, KG *

Enter Weight

BMI calculation

BMI calculation, this BMI calculator does not take into account muscle mass or fat.

BMI calculation Metric

BMI calculation, this BMI calculator does not take into account muscle mass or fat.

Severe Thinness

Your weight is below 16 which is Severe Thinness.

Moderate Thinness

Your weight is 16 - 17 which is Moderate Thinness.

Low weight

Your weight is below 18.5 which is Mild Thinness

Normal Weight

Your weight is normal is between 18.5 - 24.9

Overweight

Your BMI indicates over prisoner is between 25.0 - 29.9

Obesity Class I

Your BMI indicates obesity your BMI is greater than 30.0 - 35.0

Obesity Class II

Your BMI indicates obesity your BMI is greater than 35 - 40

Obesity Class III

Your BMI indicates obesity your BMI is greater than 40 +

Age *

Enter Age

Gender

Male
Female

Diabetes

Hypertension

layout 4

Sleep Disorder

Bone Problems

Obesity Related Problems

If yes, briefly explain:

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Respiratory Problems

Compulsive Eating

Gastro Esophageal Reflux

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Low Expectations

Digestive System Problems

Do you smoke?

Hiatal Hernia

If you answered yes, are you in treatment and what is your treatment?:

What kind of diets have your carried out? (how long?):

Any allergies that the doctor should know about? (please list):

Currently taking Medications? (please list):

Have you had previous abdominal surgeries? (If yes, explain):

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Who is your patient coordinator?:

Would you like to add Medical Complications Insurance:

How did you hear about us?:

Not listed on how you heard about us? type in here:

Do you have a friend or family member that would like to refer to us? Receive $100 per patient referral:

If you answered yes, please write down your referrals names and cell phone numbers:

Are you a previous patient?

Please enable JavaScript in your browser to complete this form.

Name *

First

Last

Layout

Choose Procedure *

Choose Procedure

Choose Surgery Destination City: *

City

Choose Surgeon: *

Select Surgeon

Layout

Email 📩 *

Phone 📞 *

phone number

Layout

We know you can get busy through out the day. Can we correspond through cellphone text for your convenience?

Send text *

Medical History

Measuring in Imperial or metric

Feet
metric

Layout

Height In *

Enter Height

Height CM *

Enter Height 1.65

Weight, Lb *

Enter Weight

Weight, KG *

Enter Weight

BMI calculation

BMI calculation, this BMI calculator does not take into account muscle mass or fat.

BMI calculation Metric

BMI calculation, this BMI calculator does not take into account muscle mass or fat.

Severe Thinness

Your weight is below 16 which is Severe Thinness.

Moderate Thinness

Your weight is 16 - 17 which is Moderate Thinness.

Low weight

Your weight is below 18.5 which is Mild Thinness

Normal Weight

Your weight is normal is between 18.5 - 24.9

Overweight

Your BMI indicates over prisoner is between 25.0 - 29.9

Obesity Class I

Your BMI indicates obesity your BMI is greater than 30.0 - 35.0

Obesity Class II

Your BMI indicates obesity your BMI is greater than 35 - 40

Obesity Class III

Your BMI indicates obesity your BMI is greater than 40 +

Age *

Enter Age

Gender

Male
Female

Diabetes

Hypertension

Layout 3

Sleep Disorder

Bone Problems

Obesity Related Problems

layout 4

If yes, briefly explain:

Respiratory Problems

Compulsive Eating

Gastro Esophageal Reflux

Layout

Low Expectations

Digestive System Problems

Do you smoke?

Layout

Hiatal Hernia

If you answered yes, are you in treatment and what is your treatment?:

What kind of diets have your carried out? (how long?):

Any allergies that the doctor should know about? (please list):

Currently taking Medications? (please list):

Have you had previous abdominal surgeries? (If yes, explain):

Layout

Who is your patient coordinator?:

Would you like to add Medical Complications Insurance:

How did you hear about us?:

Not listed on how you heard about us? type in here:

Do you have a friend or family member that would like to refer to us? Receive $100 per patient referral:

If you answered yes, please write down your referrals names and cell phone numbers:

Are you a previous patient?

What happens next

Your team reviews the details.

Your information helps the team understand your request and coordinate the next step. Medical recommendations and clearance come from your clinical team. If you need help or have not received a response, call (619) 313-6596 or text JC at (619) 635-7141.

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