A Bariatric Coach Registration Form

A Bariatric Coach - Registration Form

2026 - Thursdays 12 pm PST
A Bariatric Coach

Congratulations on taking this step to join A Bariatric Coach! If you’re preparing for bariatric surgery, or navigating life after surgery, you already know that success isn’t just about the procedure. The psychological and behavioral changes are just as important. Your habits, triggers, emotions, thoughts, behaviors, and lifestyle took years to develop and does not automatically change overnight.

This educational/coaching program is designed specifically for individuals pre- and post-bariatric surgery who want practical tools, support, and evidence-based guidance to help them stay on track long term.

DATES: The first Thursday of every month. 12 pm PST

TOPICS: Topics will rotate monthly, and each month will feature a new set of discussions. You can register for one month at a time and decide whether to continue or take a break.

ZOOM link to be provided the week before group.
Participant Information
Name*

First NameLast Name
Phone Number*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Date of Birth*

MonthDayYear
Date
I am pre-bariatric surgery.I am post-bariatric surgery.
Surgeon's Name (or clinic/hospital where you had the surgery):
Have you ever been seen at everyBody Behavioral Health: