Bariatric Surgery – Online Informational Seminar

Our Program


1. Read these directions completely

2. Watch the video in its entirety.

3. You will need to write down the web address on the last page of the video in order to get to the quiz page. Don't close out the video until you see this address.

4. Take the quiz and pass with an acceptable score.

5. Print out these forms and complete in their entirety. You will have access to the forms once you pass the quiz:

  • SLPG Intake Form
  • Bariatric Services Mental Health Assessment form
  • Medical History Form
  • Food Record Form
  • Physician Name Form
  • Directions To The Office, if necessary

6. Mail 5 forms to:

St. Luke’s Weight Management Center
Surgery Patient Intake
240 Cetronia Road
Suite 205 North
Allentown, PA 18104


Fax to 1-833-816-7512. You must include the fax cover sheet provided to you once you pass the quiz. 

7. Once we receive the completed forms in our office, we will contact you to make an initial office visit. If you do not hear from us within 7 days of mailing your forms, you can call us at 484-426-2600.

Watch the Video

Click on the image below to play the video. The presentation is 42 minutes in length, so the file may take a few minutes to download. Please be patient