Don't hesitate to fill out the form even if you haven't yet decided whether you want or need bariatric surgery. Name Age Preferred units Metric (cm, kg) Imperial (in, lbs) Length (cm) Length (ft & in) Weight (kg) Highest lifetime weight (kg) Weight (st & lbs) Highest lifetime weight (st & lbs) Chronic illnesses Additional information/questions Email address double check your email address! Phone number (with country code) I give my consent to Bariatric Services AS for the processing of the personal data in the above form in accordance with the privacy policy given herein in order to assess whether the bariatric surgery is indicated to me. NameThis field is for validation purposes and should be left unchanged.