Foothills Weight Loss Weight Management
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Your weight?
Your height?
Do you have an obesity-related disease or condition?
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If yes, which obesity-related conditions do you have? Please check all that apply.
Diabetes
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Have you had bariatric surgery?
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If yes, which bariatric procedure and when was it performed?
What would you like to achieve through the Foothills Weight Loss Management Program?
Where did you hear about Foothills Weight Loss?
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Is there any additional information you'd like us to know?
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