Northwest Weight Loss Surgery Patient Forms

For your appointment, please fill out the applicable form(s) and bring with you on the date of your appointment.

First Appointment at Northwest Weight Loss Surgery

Please call the office for your personal code to complete your patient registration prior to your first visit, once you have your code click on the following link:
 https://thelapband.nextechweb.com/patient

Click here to download a paper version of the Patient Registration Form.

Psychological Evaluation

If you are not using our therapist for your Psychological Evaluation, please print this letter and take to the therapist you are seeing: NWWLS Psychological Evaluation Criteria.

Cosmetic Services Consultation

Please fill out our Envisage Cosmetic Services Patient Registration Form and bring with you.

If you have any questions regarding these forms, please contact us or call (425) 385-2263.