Bariatric Surgery Screening Form

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Watch the Video and Complete the Screening Form

The first step in the weight loss (bariatric) surgery process at Baystate Health is an in-depth screening. We want to make sure you're a good candidate for weight loss surgery and that you understand what to expect.  

The screening has two parts, and you’ll be able to complete both from this page. 

First, watch the video. Then answer the questions in the form that follows it. Submit the form by clicking on the Submit button.   

After you submit the form, you’ll receive an application to the program, along with a health questionnaire. Complete and return these forms to our office via mail or fax. After we review your information, we’ll contact you to schedule a virtual telehealth visit. 

Please Note: To qualify for bariatric surgery at Baystate Health, you must have a BMI (body mass index) of 35 or higher with a comorbidity or 40 or higher without comorbidity. Comorbidity means that you have another illness or disorder in addition to obesity, like diabetes, high blood pressure, high cholesterol, sleep apnea, or fatty liver disease.

Step 1: Watch the Video

STEP 1: Watch This Video — the Baystate Health Bariatric Program

PASO 1: Mira este video — "El Programa de Salúd Bariátrica de Baystate Health

Calculate Your BMI
Body mass index, or BMI, is a reliable indicator of weight status for most people. We use BMI to screen for potential health problems based on a person’s weight category. The CDC’s (Centers for Disease Control and Prevention) BMI calculator is a good tool for calculating your BMI and your corresponding weight category.

Questions About the Baystate Health Bariatric Program?

We perform bariatric surgery in Springfield and Greenfield. As you move through the bariatric surgery screening process, our Bariatric team is available to answer your questions.

Manage Your Health Information Using MyBaystate
Sign in online or download the MyBaystate patient portal app to access your health information.

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