Joseph lost 180lbs with the LAP-BAND procedure

Patient Forms

The information you provide will help us to determine if you are an appropriate candidate for surgery and assist us in determining if bariatric surgery is a covered benefit under your insurance plan.

All information included on the Pre-Operation Form will be deemed "Protected Health Information" and may be released to insurance payors, in accordance with Title 45, Code of Federal Regulations, Section 160.103.

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Click here to download forms
Please bring completed forms to your first appointment.

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Weight Loss Surgery Seminar

WHEN: May 29 at 6:30pm
WHERE: Baylor Regional Medical Center of Plano - Conference Room

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You Can Afford
Weight Loss Surgery
LAP-BAND® - $9,900*
Gastric Sleeve - $12,200*
Gastric Bypass - $17,200*

Whether you use insurance, choose to finance, or elect self-pay, Nicholson Clinic is committed to helping you afford the surgery you need.

*Please note – financing and cash patient procedure costs are all-inclusive. There are no extra out-of-pocket charges other than those listed above. Insurance patients are responsible for deductibles and co-pays as defined by law and your insurance company.

*Click here to learn more.

D Magazine's Top Bariatric Doctors Five Years in a Row

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