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Online Seminar Quiz

Congratulations on taking your first step! Now, please take a moment to complete the following short quiz to to be eligible for an in person surgery consultation with with Dr. Stephen Malley or Dr. Nicole Fearing. At your consultation one of our surgeons will meet with you and help you decide if weight loss surgery is the right answer for you

If you are having trouble submitting this form please call our office and ask for Linda. She will be happy to assist you.

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How did you hear about our program?

1. Which of these disease processes are either caused by or made worse by being obese? *

a. Diabetes b. High blood pressure c. Sleep Apnea d. Infertility & menstrual problems e. All of the Above

2. With diets, exercise and behavioral changes, most people can lose up to? *

a. 5% of their excess weight b. 10% of their excess weight c. 15% of their excess weight d. 20% of their excess weight e. 25% of their excess weight

3. What are the criteria for surgery? *

a. BMI greater than 40 b. BMI greater than 35 with co-morbid illness c. BMI greater than 30 with co-morbid illness d. History of failed weight loss e. All of the above

4. LAP-BAND is a ________________ procedure.*

a. Restrictive b. Malabsorptive c. Restrictive and malabsorptive d. Non reversible e. None of the above

5. The key to the success of the LAP-BAND is ________________. *

a. No need for follow up b. Non reversibility c. Adjustability d. It's a quick fix e. All of the above

6. What are the potential problem foods with the LAP-BAND? *

a. Thick doughy breads and thick meats b. Chicken c. Fresh fruit d. Vegetables e. Potato Chips

7. The Gastric Sleeve is a ________________ procedure. *

a. Restrictive b. Malabsorptive c. Restrictive and malabsorptive d. Reversible e. None of the above

8. How often is the Gastric Sleeve adjusted? *

a. Every month b. Every 3 months c. Once a year d. Never e. Only when you get hungry

9. The safety of the Gastric Sleeve is: *

a. Better than the LAP-BAND b. Not as good as the bypass c. Not quite as good as the LAP-BAND but well better than the bypass d. Not as good as the band or bypass e. The safest thing out there

10. Morbid Obesity: *

a. Is a chronic medical condition b. Has long reaching consequences c. Is caused by multiple factors d. Has surgery as the most effective tool for sustained weight loss e. All of the above

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By selecting this box, I certify that I have watched the entire Malley Surgical Weight Loss Center online video seminar.

In addition I certify that I will bring in a completed new patient packet to my first appointment.

Please click here to download the new patient paperwork to bring to your appointment.

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5820 Lamar Avenue
Suite #200
Mission, KS 66202
Phone: 913-492-2530
Fax: 913-492-2576

Malley Surgical Weight Loss Center
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