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Bariatric surgery psychological evaluation template

Gastric Bypass Pre-Surgical Psychological Evaluation Intake Form 2025

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The document is an intake form for a psychological evaluation required before gastric bypass surgery at Central Iowa Psychological Services. It collects personal data, medical history, weight and dieting history, nutrition habits, exercise status, and goals related to the surgery. The form aims to assess the patient's readiness and motivations for undergoing bariatric surgery.

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How long is a psych eval for bariatric surgery?

Bariatric surgery psych evals include a brief interview and several psychological tests. They typically take less than two hours to complete. Dr.

What is the pre op assessment before bariatric surgery?

Assessment before weight loss surgery Before you can have weight loss surgery, your GP will refer you to a team of specialists. They will assess your: physical health using blood and tests, X-rays and scans to check for things like blood clots, ulcers and hernias.

How much does a bariatric psychological evaluation cost?

How much does a bariatric evaluation cost? A psychological evaluation for bariatric surgery is an investment of time, energy, and money. The cost for a bariatric evaluation is $2,038, which covers the cost of the clinical interview, testing, and the written report.

What is a psychological evaluation for bariatric surgery?

Much like how your health care provider must clear you physically before you can undergo surgery, a mental health screening for bariatric surgery is simply a check on your mental and emotional health to make sure youre a good candidate for this life-changing surgery.

What are the psychological issues following bariatric surgery?

Specific literature on bariatric surgery indicates a higher prevalence of psychological co-morbidities such as mood disorders, eating behaviour disorders and psychological distress in bariatric surgery candidates [53, 54] along with anxiety, personality disorders, alcohol use and low self-esteem when compared to

bariatric surgery evaluation sample report

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What is a psychosocial evaluation of bariatric surgery patients?

Most psychological evaluations involve a clinical interview and, often, psychological testing to assess bariatric knowledge, adherence, eating behaviors, mood, substance use, cognitive functioning, and psychiatric history.

What is included in a psychosocial evaluation?

The primary objectives of a psychosocial assessment include understanding the individuals background, assessing psychological functioning, evaluating social functioning, identifying strengths and resources, and determining needs and challenges. The first step includes understanding the individuals background.

What is a psychosocial aspect of obesity?

Weight-related stigma, discrimination, and societal pressures can lead to chronic stress, social exclusion, and diminished access to resources and opportunities. These social factors can exacerbate psychological distress and contribute to the development of mood disorders and other mental health issues.