How to Refer A Patient

When you refer a patient to New Life Bariatric Center please provide the following helpful information before your patient’s initial evaluation:

1. Referring Provider Information: Please list your name, phone number, e-mail address, and other pertinent contact information.

2. Patient Information:

Comprehensive history and physical exam within the past year, including the following information:

  • Documentation of patient’s compliance to previous medical regimens
  • Current height, weight, BMI, and comorbidities
  • List of allergies and current medications
  • List of non-surgical weight loss attempts. (Patients insured outside of BCBS-Florida routinely must have at least six months of medically supervised dieting within the past year, with monthly visits documenting weight, diet, and lifestyle modifications.
  • Screening for treatable causes of obesity

Labwork done within the past year:

  • B12
  • CBC
  • Comprehensive metabolic profile
  • Fasting glucose, insulin level, and lipid profile
  • Ferritin
  • GGT
  • HgA1C
  • Iron and iron saturation
  • PTH
  • RBC folate
  • TSH
  • Uric acid
  • Vit D (25 hydroxy only)
  • Vitamin A

Diabetic patients should have a urine for microalbumin, and do not need a fasting insulin level.

Copies of office visits:

  • Copies of any recent visits related to obesity within the past year
  • Patient compliance with visits and follow up with your office
  • Reports of special evaluations or tests IF done in the past, including:
  • Cardiac ECHO, cardiac catheterization
  • Evaluations by an endocrinologist, cardiologist, or a pulmonologist
  • Recent ABGs and PFTs
  • Sleep study
  • Additional information:

  • Copy of referral
  • If you have concerns about the patient’s compliance, stability or readiness to proceed with bariatric surgery, please advise us as soon as possible.
  • Patients with poorly controlled diabetes and hypertension should be optimally controlled prior to surgery. Patients who are non-compliant with diabetes care and prescribed medications in general often have poor outcomes following gastric bypass because of continued non-compliance.

3. Mandatory tests required before gastric bypass surgery:

  • A gallbladder ultrasound (if patient still has a gallbladder). An ultrasound done within the past few years is acceptable.
  • Pulmonary function testing (spirometry) for patients who have a BMI >60, are smokers, have asthma, COPD, or severe sleep apnea.

4. Additional tests or evaluations that may be recommended before surgery (all testing/evaluations can be done in the patient’s community, or arranged in Jacksonville):

  • Sleep study: suggested for patients who have multiple symptoms of sleep apnea. It is estimated that 80 percent of patients enrolled in bariatric surgery programs have sleep apnea. Treatment for sleep apnea is critical prior to surgery to decrease the risk of peri-operative respiratory complications.
  • Cardiology evaluation: suggested for patients with ASCVD, chest pain, dyspnea at rest, etc.
  • Pulmonary evaluation: for patients with symptomatic lung disease, severe sleep apnea, etc.
Tell a Friend