Apply Now: Weight Loss Surgery in Mexico

Please check box for any of these medical conditions you have or have a history of, then fill out box below with the date of diagnosis, treatments received and other necessary information.

PLEASE TAKE YOUR TIME TO REVIEW THE FOLLOWING:

I agree the statements I’ve made above are truthful, honest, and accurate. I understand that if I lie, mislead or fail to tell the truth, there can be serious consequences including, but not limited to: my physical wellbeing and health, mortality (death), complications, poor surgical outcomes, I may incur additional fees, and may cause the surgery to be cancelled without any right to money already paid.

I am interested in undergoing surgery with Renew Bariatric’s doctors. I understand that Renew Bariatric is a facilitator, and is not a medical provider. I have read thoroughly, and agree to the Terms of Conditions (new window), Deposit Policy (new window) and the Privacy Policy (new window). I’ve read Renew Bariatrics’ HIPAA Notice of Privacy Practices and Communication Policy (new window), and I agree with the terms therein.