Getting Started
Note: you will need to have Adobe Reader in order to open the forms on your computer. Click the Adobe Icon and you will be taken to the installation page:
Click the link below (picture of the form) to open a new window containing our intake forms. The forms include a health questionnaire, privacy statement, and some simple questions. If you have not yet had contact with our office, please call 636-296-9988 to let our Doctors or Office Manager know that you will be returning these completed and required intake forms. Our office will contact you once this information has been reviewed by our Doctors and at that time an appointment can be set or our Doctors can consult with you over the phone or video conference.
Instructions:
Online:
These forms can be filled out online / on your computer. Simply type in the boxes shaded blue or lines and check boxes that are available. (Important: Type your name on the lines where the "Signature" is requested if you will be filling out the forms online and emailing them to us. A verbal confirmation of signature will be performed once the forms are received). When you are finished, please save the document to your desktop (so that it is easy to find later) and title it with:
"Your Name, DWLC".
You can then add it as an attachment to an email and send it to us. The address is listed below:
Email Address:
doctorsweightloss@yahoo.com
Mail:
Simply print the forms (again, you can fill them out online by typing or simply print and fill out the forms with a pen). Once printed, send them back to us at the following address:
Physical Address:
Doctors Weight Loss Center
Attn: Confidential, Dr. Georgia Dr. Bates
2315 Highway K
O'Fallon, MO 63366
Fax:
The completed forms can be faxed to: 636-272-6995
Questions? Please do not hesitate to contact our office for any questions or help that you may need:
636-296-9988
Click the link below (picture of the form) to open a new window containing our intake forms. The forms include a health questionnaire, privacy statement, and some simple questions. If you have not yet had contact with our office, please call 636-296-9988 to let our Doctors or Office Manager know that you will be returning these completed and required intake forms. Our office will contact you once this information has been reviewed by our Doctors and at that time an appointment can be set or our Doctors can consult with you over the phone or video conference.
Instructions:
Online:
These forms can be filled out online / on your computer. Simply type in the boxes shaded blue or lines and check boxes that are available. (Important: Type your name on the lines where the "Signature" is requested if you will be filling out the forms online and emailing them to us. A verbal confirmation of signature will be performed once the forms are received). When you are finished, please save the document to your desktop (so that it is easy to find later) and title it with:
"Your Name, DWLC".
You can then add it as an attachment to an email and send it to us. The address is listed below:
Email Address:
doctorsweightloss@yahoo.com
Mail:
Simply print the forms (again, you can fill them out online by typing or simply print and fill out the forms with a pen). Once printed, send them back to us at the following address:
Physical Address:
Doctors Weight Loss Center
Attn: Confidential, Dr. Georgia Dr. Bates
2315 Highway K
O'Fallon, MO 63366
Fax:
The completed forms can be faxed to: 636-272-6995
Questions? Please do not hesitate to contact our office for any questions or help that you may need:
636-296-9988
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