Book Appointment Shelbyville Road 502.974.3447   |   Dixie Highway 502.882.8680

Weight Loss Appointment Form

Kindly complete the form and one of our experienced weight loss specialists will get in touch with you promptly.

Weight Loss Form

(If any of the four questions pertaining to their heart is answered with a yes, the patient will need to see a cardiologist for clearance. The patient can have their information faxed to us brfore the visit.)

(If the patient does carry this particular insurance they cannot be seen. We cannot collect a co-payment from them for the visit. Our doctors cannot legally see them.)

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