Appointment Request Go to the navigator!Not sure which weight loss option is best for you?Try our online weight loss navigator! If you would like a consultation with JourneyLite Physicians please complete the form below! "*" indicates required fields Step 1 of 5 - Contact Information 20% Appointment Interest-Please select the program(s) in which you are interested!*Surgical Weight LossRevision of Prior Weight Loss SurgeryGastric BalloonMedical Weight Loss (Adipex, WeGovy, etc)Psych Eval For Surgical Weight LossCombination Surgical & MedicalCancel AppointmentThere is a brief online screening process for weight loss medication appointments. Please click here to complete your online screening and request a consultation!Which procedure(s) have you had in the past? Gastric bypass or VBG (stomach stapling) Gastric band Gastric sleeve Duodenal switch ESG (endoscopic sleeve gastroplasty) SIPS, SADI, or LDS procedure We do not offer surgical revisions for this procedure due to increased risk and poor long-term results. Medication treatment options are available, however. Please change "Appointment Interest" above to "Medical Weight Loss" if you are interested in proceeding!Your Name* First Last Your Email* Enter Email Confirm Email Date of Birth* MM slash DD slash YYYY Age*Please enter a number from 18 to 99.Phone* Height (ft)*Please enter a number from 4 to 7.(for example for 5' 2", enter 5)Inches*Please enter a number from 0.5 to 11.5.(for example for 5' 2", enter 2)Weight (lbs)*BMIYour Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Preferred Location(s)*CincinnatiColumbusDaytonNorthern KyVirtual Have you watched the "Meet Dr. Curry Online" infosession?*YesNoPlease click here to watch the online infosession before requesting an appointment!Select Procedures of Interest Gastric Sleeve Gastric Bypass Lap Band SIPS Procedure (Loop Duodenal Switch) Other Select Procedures of Interest Spatz Adjustable Gastric Balloon Orbera Gastric Balloon Select Medication Interests Adipex Contrave Phentermine Qsymia Saxenda WeGovy Unsure Select GERD Treatment Interest(s) Stretta Procedure Lap Nissen Combined Interests Adipex Contrave Gastric Balloon Gastric Bypass Gastric Sleeve Lap Band Phentermine Qsymia Saxenda SIPS Procedure WeGovy Cancel Appointment On MM slash DD slash YYYY Additional Message Pulmonary History* I have never had any of these problems. Blood clot to lungs (pulmonary embolism) Emphysema COPD Other pulmonary issue (please explain below) Check any issues that you currently have, or have had in the past.Pulmonary CommentsCardiac History-Check all that apply!* I have never had any of these problems. Chest pain/angina History of heart surgery History of heart stent or angioplasty Previous heart attack Other cardiac issue (please explain below) Check any issues that you currently have, or have had in the past.Cardiac CommentsGastrointestinal History* I have never had any of these problems. History of Crohn's disease History of cirrhosis History of surgery for hiatal hernia (Nissen fundoplication) History of any other type of hernia repair (please explain below) Other abdominal surgery (please list below) Check any issues that you currently have, or have had in the past.Gastrointestinal CommentsDo you take any steroids by mouth on a regular basis? (e.g. prednisone, methylprednisolone)*YesNoPlease list your steroid regimen: Terms Of Service Submitting this form does not constitute a doctor-patient relationship with Center for Metabolic & Bariatric Surgery, LLC/dba JourneyLite Physicians. Information submitted will not be shared with any third parties except for direct affiliates of Center for Metabolic & Bariatric Surgery, LLC. By checking the box below, I give permission for this information to be transmitted to JourneyLite Physicians. Agreement* I agree to the terms of service Coupon Code How did you hear about us? TV Google/Search Ad On The Internet Facebook Twitter Pinterest Radio Billboard Another Patient Another Doctor EmailThis field is for validation purposes and should be left unchanged. Δ Infosession Meet Dr. Curry online! Navigator Interactive Online Weight Loss Navigator. eStore Protein, Vitamins, & More!