You have questions.
Let us share our experience with you.

One of the most important steps you can take is seeking help from a Surgical Weight Loss professional. Our staff can help answer your questions, share their experiences, and help you take the first steps toward a healthy life.

Call Us

We're open weekdays, 8 a.m. to 4:30 p.m. You can call toll-free or make a local call if you're in the Ashland area. We receive hundreds of calls a day, so if you reach our message center, please leave your information and we'll call back the same day.
Toll Free: 888.377.KDMC (5362)
Local: 606.408.5193

Surgical Weight Loss Prescreening Survey

Want to setup an appointment? Fill out this prescreening form and we'll give you a call.

^* denotes a required field

First Name:  ^*

Last Name:  ^*

Daytime Phone Number:  ^*

Evening Phone Number: 

Address Line 1:  ^*

Address Line 2:  

City:  ^*

State/Province:  ^*

Zip/Postal Code:  ^*

Date of Birth:   [None]     ^* must be 18 or older

Height:  feet  inches ^*

Weight:  lbs. ^*

BMI:  ^* calculate 

Information for previous surgeries and current medical conditions is required for assessing eligibility for surgical weight loss. Please make sure this information is as complete as possible. If you have no prior surgeries or no current medical conditions, please type 'none.'

Previous surgeries (please list): ^*
 

Current medical conditions: ^*
 

Insurance:  ^*