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Bariatric Surgery Appointment Form

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Please print and fill out the appointment form if you are scheduled to see Dr. Goldstein in the office about weight loss surgery, and bring it with you to your appointment. (Note the form is in .pdf format, so you may need to download Adobe Acrobat Reader first by clicking the Adobe link below.)

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Click the icon to download the form




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If you do not already have Adobe Acrobat Reader installed on your computer, you can download and install it for free from Adobe's website by clicking the link below.

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