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Pre-Operative Information
Required Pre-Authorization Consultations
As part of your pre-operative clearance for surgery, I require you to have at least a psychological and pulmonary/critical care clearance. This is another way in which I work towards the safest possible operative experience and the best outcome for you. As noted previously, this is how I have done it for the last 1984 – plus cases and it has been very successful.
It would be ideal if when you come to seem me in consultation that you have completed these elements of your work-up. If they haven’t been done then I’ll order them when you come to see me. That is okay too, if you so desire. But, this may delay your approval because many insurers are asking for the “complete work-up including the psychological clearance and any other pre-operative evaluations that have been done.” Many will not review our request for pre-authorization until this is completed. So, it is ideal to have these two evaluations done prior to seeing me.
Take this request to your primary physician and ask for a referral to one of the practices noted below. If no referral is needed, then you can arrange this on your own. (We do allow you to use other practitioners, selectively—especially if you already have a relationship with a particular such provider OR the logistics of travel preclude you from using one of “our” doctors. But, you need to make sure that these alternate doctors contact us to guarantee that they are deriving the clearance information that we need.)
1. National Jewish East Denver 2. Colorado Pulmonary Associates
1400 Jackson St 1721 E 19th Ave, Suite 366
Denver, CO 80206-2761 Denver, CO 80218
303-270-2420 303-863-0300
**If alternate Pulmonary/Critical Care professionals are preferred by you or your primary physician, we will usually accept their clearance and analysis if they are board-certified and comfortable with this type of evaluation. If questions or concerns please feel free to just ask. They can also contact us directly.
II. Psychological consultations:
1. Melinda McMahon, PhD 4. Gene Gross, LCSW
4500 E 9th Avenue, Suite 720 739 Sherman Street
Denver, CO 80220 Denver, CO 80203
720-299-5897 303-868-7897
2. Kevin Reilly, PhD 5. Kwai Kendall-Grove, PhD
198 Union Blvd 1720 S. Bellaire, Suite 805
Lakewood, CO 80228 Denver, CO 80222
303-798-4913 303-662-9670
3. Eating Disorder Center of Denver 6. Hilary Silver, LCSW
Joseph Christenson, MD & Nancie Ziemke, PhD 1890 Gaylord St
950 S Cherry St, Suite 1010 Denver, CO 80206
Denver, CO 80246 720-935-7393
303-771-0861
- If alternate Psychologic professionals are preferred by you or your primary physician, we will usually accept their clearance and analysis if they are board-certified and comfortable with this type of evaluation. If questions or concerns please feel free to just ask. If you are presently under the care of a licensed psychiatric professional or if you are going to see someone who is not routinely doing such pre-op evaluations, she/he CAN do your psych clearance. However, I like them to use my preferred framework that is available from our office. They have to call or e-mail us to get a copy of the template.
III. Cardiology consultations:
If you are 50 years of age or older, I also require cardiologist clearance with at least some type of evocative stress test. Once again, we liberally use this type of screening to further improve the margin of safety in all that we do.
The practice that does the vast majority of our cardiac clearance is:
1. Cardiovascular Associates, P.C. 3. Cardiovascular Associates, P.C
4101 W Conejos Place – Suite 100 8300 Alcott Street, Suite 100
Denver, CO 80204 Westminster, CO 80031
303-595-2600 303-426-5154
2. Cardiovascular Associates, P.C
4545 E. 9th Avenue, Suite 610
Denver, CO 80220
303-331-9121
If alternate Cardiology professionals are preferred by you or your primary physician, or you are presently under the care of a cardiologist, we will usually accept their clearance and analysis if they are board-certified and comfortable with this type of evaluation. If questions or concerns please feel free to just ask. They can also contact me directly.
I appreciate your facilitation of these consults, as needed. From experience we have learned that having this done PRIOR TO your appointment with me significantly speeds up the approval process. But, completion of this step is not required prior to your appointment.
– Michael A. Snyder – MD, FACS, PC
- Stacie E. Perlman - MD
If you have recently been to one of my free Seminars, here is the information that you will need to read, review, complete and return to become one of my patients.
Great news and for your convenience, these forms can now be entered directly into! Please click and open each document listed below.
Emmi is an interactive patient education series that manages the expectations of people who are scheduled for surgery. It covers a wide variety of information about many surgical procedures, it serves as an educational tool to effectively illustrate and synthesize difficult, intimidating and often discouraging information about surgeries.
Emmi will walk you through the entire surgical experience from pre-op to post-op, including risks and alternatives. And, while you are being educated, each click is recorded to create a permanent record of what you saw, heard and did while viewing the program. Learn more about Emmi here.
Form Downloads for New Patients (Microsoft Word format)
Note: For the downloadable files below, you will only be able to enter information into the gray boxes. When you have entered the information into the required field(s), you will need to press the tab key on your keyboard; this will move the cursor to the next gray box. When you have completed the form(s), please print a copy for your records and then email the document(s) to Corinna@denverbariatrics.com by following the next steps:
1. To send us the file you will more then likely need to save the document to your computer then attach it to the email you will be sending to Corinna@denverbariatrics.com.
2. Note that some of the documents are for you to read and informational in nature only and some of them must be filled out by you and ready at your Consultation appointment. Although we request that you email the documents to us upon completion, and please bring a printed copy with you to your appointment.
You can fill everything out at your leisure when you have the time and information at hand that you will need. In this way we have all the information on you that we need and you have all the information that you need to go forward.
Very Truly Yours,
Michael A. Snyder, MD, FACS, PC
Stacie E. Perlman, MD
Downloadable Files:
Weight Loss Attempts Questionnaire
Must be completed
New Patient Information Sheet
New Patient Information
Medical Information Questionnaire
Must be completed
Lap-Band Checklist Prior to Surgery
Informational
Gastric Bypass Checklist Prior To Surgery
Informational
Bariatric Patient History Questionnaire
Must be completed
Authorization to Release Healthcare Information
Must be completed
To All My New Patients and Prospective
Insurance Approval / Patient Waiver Agreement (Page 11) – Must be completed
Photograph Release & Waiver (Page 13) – Must be completed