New Image Bariatric Surgical Associates Patient Resources

We have many resources available so patients know exactly what to expect before, during, and after surgery. Information guides and diet plans are available on this page so you can print and view them at home. For your convenience, there is also a health questionnaire and several consent forms on this page.

Get Adobe Reader

Patient Forms

Patient Questionnaire – Coming Soon

Informed Consent for Laparoscopic Distal Gastric Bypass

Informed Consent for Open Distal Gastric Bypass

Informed Consent for Laparoscopic Proximal Gastric Bypass

Informed Consent for Open Proximal Gastric Bypass

Patient Information

Patient Information Guide

Insurance and Financing

As a service to our patients, we are pleased to offer the CareCredit card, the nation's leading patient payment program. With CareCredit you can finance 100% of your dental care and there are no upfront costs, no annual fees, and no pre-payment penalties. So, you can begin your treatment today and conveniently pay with low, monthly payments.

CareCredit offers a full range of payment plans so you can find one that works best for you. With the popular No Interest Payment Plans* there are no interest charges if you pay your balance in full within the specified time period. Monthly payments can be as low as 3% of your balance. For procedure fees from $1,000 and up, CareCredit offers 24, 36, or 48 month plan options with low monthly payments available.

CareCredit can be used by the whole family for ongoing treatment without having to reapply. And by using CareCredit for your dental care, you can save your other credit cards for household or unplanned expenses. It only takes a few minutes to apply for CareCredit and you'll receive an online decision in seconds!

Apply Now or see our staff for more details.
* terms and conditions

The Real Thing Is Now Here!

Inpatient Dietary Protocol for Proximal Gastric Bypass

Post Op Instructions at Home for Distal and Proximal Gastric Bypass

Diet Guidelines

Post Op Diet 1 (Gastric Bypass Liquids)

Post Op Diet 2 (Mushy Foods)

Post Op Diet 3 (Semi–Solid Foods)

Post Op Diet 4 (Regular Food)