Weight-Loss Surgery Information Request Form

We know that losing weight is not easy. Choosing weight-loss surgery is a life changing decision. The Yale New Haven Health Center for Weight Management 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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First Name *

Last Name *

Email *

Zip Code *

To help us better serve you, please tell us where you are in your weight-loss journey. * I am researching weight-loss surgery options I am ready for weight-loss surgery Unsure

What's your preferred hospital? * Bridgeport Hospital Greenwich Hospital Lawrence and Memorial Hospital Yale New Haven Hospital

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Weight-Loss Surgery Information Request Form

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