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Forms & Resources


For your convenience, the following provides links to forms and documentation needed to progress through each stage of your weight loss program. In addition, you can download and/or print education handouts for your reference. As always, should you have any questions, please feel free to contact the Bridges Center at 602-251-8828.

Primary Care Physician Sample Referral Letter
Some insurance plans require a referral or authorization in order for you to see a specialist. Please make the appropriate arrangements with your primary care physician. Refer to the sample letter provided. Remember to verify that the bariatric surgeon’s office has received your physician’s referral prior to arriving to your appointment.

Weight Loss Seminar Packet
All seminar attendees receive a seminar packet upon arrival at the event. A PDF sample is provided here.

Medically-supervised Diet Requirements
Some insurance companies require that you provide documentation outlining your diet history, including monthly visits within the last two years and a physician’s signature on each monthly notation. If your insurance company requires diet history information, please print and complete the Bridges Center diet requirements form.

Insurance Verification
A completed insurance verification form must be submitted to the Bridges Center upon the completion of any weight loss seminar. If you attend a weight loss seminar at one of our Valley locations, this form will be provided at the event. If you view our online webinar, please download, print and complete the form provided here.

Frequently Asked Questions
Download our frequently asked questions document for answers to common questions. Click here for the Spanish version.

Hotel Accommodations
The Bridges Center for Surgical Weight Management has two locations on the campuses of St. Luke’s Medical Center and Mountain Vista Medical Center. We are pleased to provide a list of hotels near the hospitals as a courtesy for our patients and visitors. Though care has been taken to compile this list, the hospitals do not endorse any hotel or guarantee the accuracy of the hotel information. View our list of hotel accommodations near St. Luke’s Medical Center.

Health History
Before attending your one-on-one consultation with your surgeon, please provide the required health history information. Your health history information must be received by the surgeon’s office in time for your consultation. Click here to access the patient portal.

Additional Helpful Resources

The following are additional informational and educational materials, designed to help you throughout your weight loss efforts.

Types of Bariatric Surgery
This handout provides a summary of the types of bariatric surgery offered at the Bridges Center. In addition, this handout briefly describes each surgical procedure, outlines how each procedure affects the digestive process, provides an estimated length of stay in the hospital and summarizes statistical health benefits of bariatric surgery.

Food Intake Journal Page
Keeping a record of your food intake is an effective way to help you reduce meal portions and fat intake. This may also be helpful in providing your primary care physician and Bridges Center surgeon with additional information about diet.

Physical Activity Journal Page
Daily physical activity or exercise is essential to losing weight. Engage in at least 30 minutes of physical activity each day and record your results in a journal. In addition to tracking your exercise regime, you’ll enjoy the satisfaction of a job well done!

Body Mass Index (BMI) Chart
Need to take the Body Mass Index (BMI) chart with you? Here, we’ve provided a printable chart for your reference.

General Nutritional Guidelines: Pre- and Post-Surgery
Whether you are jump starting your weight loss program prior to surgery, or adjusting your diet following surgery, this handout provides an at-a-glance view of general nutritional guidelines. Print this out and attached it to your fridge for a helpful reminder as you prepare meals at home.

Bariatric Surgery Source: Complete Patient Guide
Bariatric Surgery Source helps obese individuals determine whether surgery is a good option.  Post-op, BSS aids weight loss surgery patients in setting, achieving and maintaining specific and realistic health and weight loss goals.


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St. Luke's Medical Center
Mountain Vista Medical Center
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Please note: Results are not 100% guaranteed and may vary from one person to another.

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