In order to start your weight loss journey please download this application, fill it out, and send it to us. Completing an application is required to verify your bariatric surgery benefits and determine whether you qualify for surgery. This is the first step in determining your path to weight loss surgery.

Return the application by emailing it to, faxing it to 503-227-2462, or mailing it to – 1040 NW 22nd Ave, Ste 500 Portland, OR 97210.