Referral Info for Weight Loss Surgery at UnityPoint Clinic | Iowa
Referral information for UnityPoint Health - Des Moines weight loss.

Referral Information

Referral Form

Please use this form to submit referrals to our office. For any questions, contact our office at 515-241-2250.

As the patient's Primary Care Physician, here are some things you can do to help your patient:

  • Have documented participation in at least six months of medically-supervised attempts at weight management with documented weights over that time period
  • Have a documented BMI ≥ 35 with serious obesity-related co morbidities, or have a documented BMI ≥ 40
  • Documented Obesity-related co morbidities include:
  • Type II Diabetes Mellitus
  • Sleep Apnea
  • Pseudotumor cerebri
  • Hypertension
  • Dyslipidemias
  • Non-alcoholic steatohepatitis
  • Venous stasis disease
  • Polycystic Ovary Syndrome
  • Intertriginous soft tissue infections
  • Stress Urinary Incontinence
  • Gastroesophageal Reflux Disease
  • Weight-related arthropathies which impair physical activity