In my info packet was the following sample letter. Hope it helps someone.

NAME has been a patient in my office since DATE. She was advised to start a weight loss program. The patient started (name of medically supoervised weight loss program) on date. She was also advised to start an exercise program such as walking, low impact aerobics, etc.

The patient was followed monthly in my office while on the above weight loss program. She was counseled regarding her diet and exercise plan. Her weights while on the diet are listed below. (FYI I need SIX months of consecutive weigh ins)

JAN

FEB

MAR

APRIL

MAY

JUNE

JULY

AUG

SEPT

OCT

NOV

DEC

NAME was examined in my office on DATE. She is considered medically cleared for bariatric surgery/Lapband.

If you require any additional information please contact my office.

Sincerely,

Dr.

They noted at the end of the sample letter that "acceptable" weight loss programs were:

LOW CALORIE DIETS(12-1500 cals)

Atkins

Pharmacotherapy with FDA approved weight loss drugs combined with exercise.

Thank you so much! I was actually going to do a "search" for a sample letter tonight, you must have read my mind!