This is the Pre-Screen Health Form of Mexico Bariatric Center.

Warning! Please read carefully, so we can get an accurate picture of your health.

Any additional medical history that has not been covered, please indicate below. Do you have any questions for your surgeon or medical team?

I Agree to the Terms: I understand that full disclosure is necessary to my medical safety, I have filled out this medical history to the best of my knowledge, and I have answered these questions with complete honesty to insure my health and safety. I agree with Terms of Service with includes the Refund + Cancellation Policy, Privacy Policy and Disclaimer.

We Respect Your Privacy and Confidentiality. We'll never sell or divulge your information to any 3rd party. Your information will only be released on a strictly need-to-know basis, with your prior approval first. You also agree to be followed up with our coordination team via email, phone, and occasional text messages.