Questions

To request an appointment with a weight loss specialist, please fill out the form below, watch the video that will load after the form is complete and complete a short questionnaire. Please note, you must meet the following criteria before submitting a form:

• You must be nicotine free for 3 months
  • If you are currently smoking, vaping, chewing tobacco or using nicotine in any form, please visit our smoking cessation resources and Medical Weight Loss site for further information.
• Your BMI must be higher than 40
  • If you do not know your BMI, please use the BMI Calculator to determine your BMI
  • If your BMI is lower than 40 please visit our Medical Weight Loss resources
  • If your BMI is between 35-40 and you have a qualifying co-morbidity such as sleep apnea, diabetes, hyperlipidemia, hypertension or heart disease you may complete and submit the form below

Once your form has been submitted, and you have achieved a passing score on the questionnaire at the end of the video, a weight loss specialist will reach out to you as soon as possible. If you are an active MyChart user with University of Utah Health, our team will contact you directly through My Chart with next steps.