New Patients

Insurance Cards and Photo ID

After you have registered for the informational seminar, please send us a copy of your insurance cards (front & back) and a copy of your driver’s license or state ID. You may either fax them to us at (815) 717-8339 or email them to  We will need to verify your insurance benefits and surgical criteria before scheduling your consultation.

Understanding Your Insurance

Click here to print a copy of Understanding Your Insurance (PDF)

Health History Forms

Once you have attended our informational seminar, you will need to complete your Health History forms prior to beginning your weight loss program. This questionnaire is very important and will assist us in getting you approved for surgery by your insurance plan. This form must be sent to us prior to scheduling your consultation visit with the surgeon. We will include a copy of this form in your packet. However, you may choose to download a copy of this form below. Once completed, please return the form to our office either by mail, fax (815) 717-8339 or email:

Please include a list of your medications when you return the Health History form. 

Click here to print a copy of your Health History Forms (PDF)

Consultation Appointment

After we have received your Health History Form and have verified your insurance benefits, we will contact you to schedule your initial consultation with the surgeon.  If you do not hear from us within 2 weeks please call our office at 815-717-8744.

New Patient Forms

At your first appointment, you will need to complete a number of new patient forms. If you prefer to complete these forms prior to your appointment you may print off a copy using the link below. Once you have completed the forms you may fax them to (815) 717-8339 or bring the forms with you at the time of your appointment. If you prefer you may complete the forms when you come into the office. Please arrive at the office for your first visit at least 15 minutes prior to your appointment for the check-in process.

Click here to print a copy your New Patient Forms (PDF)

Patient Portal

BMI Surgery will send you an email invite to create your patient portal. If you did not receive this email. Please give us a call so that we may verify your email address. You may also click on the link below to create an account.

Our patient portal will give you secure access to the following:

  • View Past and Future Appointments
  • Request a New Appointment
  • View and Update Personal Demographics
  • View and Print Forms
  • View your Lab Results
  • Request Medication Refills
  • Exchange Secure and Compliant Messages with our office
  • View your balance and statements

The Patient Portal also gives the staff at BMI Surgery a secure and efficient method of providing you with answers, access to personal information, and improving the efficiency of our office staff. The Patient Portal is available to you 24 hours a day, 7 days a week, 365 days a year.

The Patient Portal is not intended to replace an office visit. It should be only be used for routine, non-urgent matters. If you are having a Medical Emergency please call 911 immediately. For other questions, concerns, or other non-emergency medical matters, please call our office during office hours.

Our physicians are on call 24/7, if you need to call the doctor regarding an urgent medical concern, please call our office at (815) 717-8744 and our answering service will get a hold of the physician on call.

Log in to Our Patient Portal

Click here to log in to our secure Patient Portal.

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