Pre-Operative Form

Thank you for your interest in oBand Surgery Centers, Inc. Our centers are located in Southern California.

The Pre-Operative form will provide us with valuable health, demographic and financial information that will help us to assist you.

All information included on the Pre-Operative Form will be deemed "Protected Health Information" and may be released to insurance payors, health care providers or other "Business Associates" of oBand Surgery Centers, Inc. in accordance with Title 45, Code of Federal Regulations, Section 160.103..

Registration

Please choose a username and password below to start on the Pre-Operative questionnaire.

Username*:
Password*:

* must contain a minimum of 6 characters.

If you already have been assigned a username and password,
click here to login.

 

Registration	Demographic	Insurance	Weight Loss History	Family History

Medications	Eating Habits	Social History	Review of System	Seminar