NEA Baptist Weight Loss Surgery

Training Conclusion - Agreement

I have completed each session and understand the material to the best of my ability. Reviewing the material does not necessarily qualify me for any weight loss surgery procedure but I am prepared to discuss it further with a qualified professional from NEA Baptist Clinic.

I understand I must complete the Bariatric Patient Packet if I am interested in pursuing surgery. 
 
I agree*
Name*
Date*
E-Mail*
Phone Number*
Please return the Bariatric Patient Packet to one of the following. 

mailing address:
NEA Baptist Memorial Hospital 
Attn: Gayla Smith, RN/Bariatric Coordinator 
4800 E. Johnson Ave.
Jonesboro, Ar 72401
email: gayla.smith@bmhcc.org
fax: (870) 972-7085

Questions:
If you have any questions while filling out your paperwork, please contact: 
Gayla Smith, RN, Bariatric Surgery Coordinator
Monday thru Thursday from 8:30am to 4:00pm. 
phone: (870) 936-2019
gayla.smith@bmhcc.org

What's Next: 
Once the forms have been filled out and returned, you will be contacted by phone to answer any questions that you may have regarding the process.