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Weight-Loss Surgery Information Request Form

Weight Loss Bariatric Form


We know that losing weight is not easy. Choosing weight-loss surgery is a life changing decision. At Yale New Haven Health our surgical weight-loss program is designed to support you throughout your journey. With our clinical expertise, compassion and support, it is possible to enjoy a healthier life, doing the things you love to do.

Our weight-loss surgery program serves those with a body mass index (BMI) of 40+, or 35-39 with accompanying health problems. Check to see if you are eligible.

To receive more information about our bariatric surgery options, eligibility and support services, please complete the form below. Once complete, we will email you our latest brochure to download.

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