We are happy to help you. To do it in the best possible way, we request that you complete the data and answer the following questions:

Name and surname

E-mail address

Telephone number with the area code


Body weight (kg)

Height (cm)

What are your main complaints at the moment?

What medications are you currently taking?

What is the reason for taking the above medications?

Which floor can you climb to without a break?

How far can you go on a flat surface?

Which surgeries, procedures or serious diseases have you had?

What do you expect from the surgical treatment of obesity?