Weight Loss Management Center Referrals

​​​​Weight-Loss SurgeryThe Weight Loss Management​ at UW Medical Center is at the forefront of the field of weight loss surgery, having provided weight loss management care to residents of Seattle, the Northwest and beyond for more than 30 years. Upon referral, each patient is evaluated by members of our multidisciplinary bariatric surgery team, which includes bariatric surgeons, nurse practitioners, nutritionists, physical therapists and social workers.

How to Refer Your Patient to the Center


Before you refer your patient

  • It is important to determine in advance if your patient has a bariatric benefit associated with his or her health insurance plan, as well as what criteria are involved.
  •  Depending on the specific insurance plan, patients may be required to have 6 months to 5 years of documented weight loss attempts.
  • If there are specific requirements by an insurance plan to document weight loss or other specific activities for surgical authorization, it is the responsibility of your patient and his or her primary care physician to fulfill those requirements prior to the referral.

Referring your patient

Please be as thorough as possible in the Reason for Referral section of the Referral Request form.
  • If there are additional referral forms or authorizations required by the applicable payer, please include them with the Referral Request form.
  • If your patient belongs to an HMO or managed care plan, ask your patient’s primary care provider to fax or mail the completed Referral Request form to us. We must receive this form before your patient’s first visit. If mailing, please allow 10 days for us to receive the completed form.

Information Your Patient Will Need to Bring to the Appointment

Your patient will need to bring his or her patient records and pertinent diagnostic tests to the first clinic visit. They may also be mailed in advance to the clinic address.

Weight Loss Management Center at UWMC-Roosevelt
First Floor
4225 Roosevelt Way NE
Seattle, WA 98105

These records should include the following information:
  • Clinic or progress notes
  • Operative report for any abdominal operations
  • Summary of patient’s condition
  • Summaries from hospitalizations relating to the patient’s condition
  • Mental health notes (if available)
  • Test results from any cardiac, renal or hepatic evaluations (if available)
  • Films and reports of abdominal studies such as upper GI, CT and endoscopy evaluations (if available)

Scheduling Appointments and Determining Eligibility

We will call your patient within 48 hours after their referral to schedule an appointment with a Weight Loss Management. At that time, your patient will also be given a date for the Weight Loss​ Patient Education Seminar, which is a program requirement.

Here are the NIH criteria that we will use to determine your patient’s eligibility for weight loss surgery:
  • BMI over 40
  • BMI of 35 or greater along with significant weight-related medical problems, such as diabetes, heart disease or severe sleep apnea
  • Smoke free for two months prior to starting our program (a UWMC Weight Loss Management requirement)
* UWMC Center for Weight Loss Management discourages gastric bypass surgery for patients over 65 years of age and lap-band surgery for patients 65-70 years of age. If you are referring a patient in the specified age range for one of these surgeries, we require a letter from the patient’s primary care provider stating why the procedure is medically necessary.

After your patient’s initial appointment with the Weight Loss Management, we will send a letter to the primary care provider with the details of the assessment as well as the agreed-upon goals for bariatric surgery.

Revision weight loss surgery The UWMC Weight Loss Management​ team will review requests for revision bariatric surgeries prior to scheduling an appointment.