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OSF Saint Francis Medical Center
Weight Loss Surgery Information Survey
*
indicates a required field.
1. Weight loss surgery is the only option for weight loss.
*
True
False
2. I need to get a referral from my doctor to start the weight management program.
*
True
False
3. Only your heart is affected by obesity.
*
True
False
4. Obesity is the 2nd leading cause of preventable death and may shorten a person's lifespan by 10-15 years.
*
True
False
5. It is impossible to gain weight back, after having weight loss surgery.
*
True
False
6. How long does the preparation stage usually take before having surgery?
*
6 weeks
3 months
6 months
8-12 months
7. Who should you call if your insurance changes?
*
The hospital
Your surgeon
No one
8. What types of weight loss surgery are offered? (check all that apply):
*
Gastric Sleeve
Gastric Bypass
Duodenal Switch
Lap Band
9. How much do vitamin supplements cost per month, after weight loss surgery?
*
$40-60 per month for good quality bariatric vitamins
$20 per month if I get generic brands at Walmart
$0, my insurance will pay for them
10. For how long after having weight loss surgery do you need to take vitamins?
*
6 months
For the rest of my life
10 years
11. For how long and how often do you have to follow up with the OSF Bariatric Long Term Clinic, after surgery?
*
Every month for 1 year
Every month for 5 years
Every year for life
I verify that I have watched all 4 videos, and understand the information (please enter your first name, last name, and date of birth here).
*
If you have questions or concerns about the information in the videos, please enter your questions here and we will discuss these with you during your next appointment.
Submit
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