Bariatric Surgery Enquiry Tool

IF YOU ALREADY HAVE A GP REFERRAL - YOU DO NOT NEED TO COMPLETE THIS SCREENING TOOL.

PLEASE CALL (07) 3153-6633 TO REQUEST FOR AN APPOINTMENT TO SEE DR WONG AND SEND THE REFERRAL TO admin@brisbanegosurgery.com.au

First Name *

Last Name *

Date of Birth *

Age *

Contact Number *

Locality of Residence *

Email Address *

Current weight *

Current Height *

Current BMI:To calculate BMI Visit https://www.gethealthyqld.com.au/tools-and-calculators/bmi-calculator

How did you find out about us? *

Details

Have you had a bariatric procedure before? *

YesNo

What procedure and when?

What procedure(s) are you most interested in? *

When is the best time to contact you?We will try out best to contact you in this timeframe, although it cannot be guaranteed due to other practice and patient commitments.

What would you like to enquire about? *

The approximate costs of having bariatric surgery with Dr WongThe unique "bespoke" bariatric program that Dr Wong offersI would like to know more about the surgeries Dr Wong offersI am unsure if bariatric surgery is right for meI would like an appointment with Dr Wong to discuss what is right for me