Name (First Last) *

Date *

Email Address *

I confirm that I have watched the complete Bariatric Surgery Information Video provided by CalvertHealth Medical Center.

I understand that the video covered the following topics:

• The physiology of obesity
• Types of bariatric surgery procedures
• Risks and benefits of surgery
• Lifestyle changes required before and after surgery
• The importance of follow-up care and long-term commitment

I acknowledge that I have received this information as part of my pre­operative education and understand the content presented. I also understand that I may ask additional questions during my consultation with the bariatric care team. *