PeaceHealth Medical Group Surgery Packet Request
If you would like to receive more information about the Oregon Bariatric Center,
including an application to enter the program, please complete the form below.
When finished, click the
button located at the bottom of the form. Please allow
two weeks for delivery. Thank you for your interest.
Questions marked with a
require a response.
Daytime Telephone Number
Format: (999) 999-9999
Date of Birth (mm/dd/yyyy)
Please provide any other questions or comments you may have about your order.