Patient Profile Information If you are a candidate for LAP-BAND® System Surgery, please complete the Patient Profile Information. You may download the form in MS Word or Adobe PDF format. Choose the appropriate link below. MS Word format (560K .doc) Adobe PDF format (240K .pdf) If you have any questions, please contact Cheryl Conwell at 317-621-2511.

---

Visit our Blog on Wordpress.com and say hello!

Home | Weight-Loss Surgery | BMI | About the Lap-Band | Candidates | Testimonials | eSTORE®
Local Stories | Risk Info | Insurance | FAQ | Patient Seminars | Profile Info | Our Surgeon | Contact Us | Links

Get up off the couch and go do something! That's the first step to successful weight loss!
Find thousands of event listings and things to do in Indianapolis at: http://www.aroundindy.com.

Copyright © 2005-2008, LapBandIndiana.com. All rights reserved.
Questions/comments? E-mail the Business Administrator.
Last update: Monday, October 6, 2008.

LAP-BAND® is a registered trademark of Allergan, Inc.