To view and print the RMAP forms and patient instruction information click on the links below.
The "Patient Information" is the required paperwork that must be completed. If you are seeking authorization from your insurance company, these forms will need to accompany all your medical record and diet attempt information. Please submit all your paperwork together. Contact your insurance to understand their approval requirements and criteria.
The "Weight Loss Surgery Cost Sheet" shows you how much you should expect to pay for the procedure.
If you live within 200 miles of Salt Lake City you will be required to attend the Risks and Benefits of Weight Loss Surgery class taught frequently each week. To see register for a class, click here.
