This online form is for physicians and other health professionals to refer a patient to the UCSF Bariatric Surgery. If you are NOT a physician or health professional, please use our Request an Appointment Form.
Please complete the form below to initiate a referral request. New Patient Appointments by phone may also be made by calling (415) 353-2804 (Bariatric New Patient Coordinator). Follow up appointments may be made by calling (415) 353-2161 (Bariatric Clinic Front Desk). This is a secure form and any information provided will be handled in strict compliance with applicable privacy laws.