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“The system you have in place has helped me feel more confident. It is as if you are holding my hand and walking me through this process. Keep up the great work.”

NewStart Patient

Your NewStart Journey Begins Today

We’re here to simplify the process so you can focus on preparing for life after surgery.

Our dedicated Care Concierge Team is here to help you navigate the often overwhelming bariatric surgery process.

What to Expect

Keeping You Informed: After we've received your insurance information, we'll connect you with a surgeon's office. We will work with the surgeon's office to have your insurance benefits verified and book your initial consultation.
Emotional Support: All patients are required to undergo an evaluation to ensure you are emotionally ready for surgery and the lifestyle changes that come afterward.
Your Dedicated Partner: Our Care Concierge will help guide you through the entire process and provide the support you need. This program is available at no cost for Memorial Hermann NewStart patients.

Start the Process

Please have your insurance information available and fill out the following fields. It should take less than 5 minutes to complete. Once submitted, our Care Concierge will contact you soon to follow up.

Fields with an asterisk are required.

Primary Insurance Information

Insurance Company *

Insurance Phone *

Group Name / ID# *

Policy / Subscriber / Member ID *

Name as it appears on your Insurance Card *

Employer Name *

Patient Information

First Name *

Last Name *

Address *

Suite

City *

State *

Zip Code *

Country *

Email Address *

Phone *

Date of Birth *

Preferred Facility: *

Enter your height and weight to calculate your BMI.

Height (Feet) *

Height (Inches) *

Weight (Pounds) *

Optional: Tell us a little more, any specific questions or concerns?

As a participant in the NewStart Program, I understand Care Concierge services will be provided to me throughout my weight loss journey. Care Concierge services include, but are not limited to, orientation to the Program, the coordination of medical appointments, and answering questions you may have along your journey.

In furtherance of my participation in the Program, I authorize my health care providers, including Memorial Hermann, to disclose and collect healthcare information from my providers for the purposes of tracking my progress and surgical outcome and, for business operations purposes, such as assessing the services offered by the NewStart program, and marketing.

Submitting this authorization is not a condition of treatment. Information disclosed pursuant to this authorization is subject to redisclosure by the recipient and may no longer be protected.

This authorization is valid throughout my participation in the Program or until revoked. I understand that I can revoke this authorization at any time.

By clicking “submit”, you understand and agree that Memorial Hermann may use the information collected to determine eligibility to participate in the NewStart Program including obtaining authorization form your insurance company, if applicable. You also understand that by clicking “submit” this constitutes your electronic signature to this authorization.

Thank
You!

Your Bariatric Coordinator will be in touch within the next few days to confirm your information and discuss the next steps in the process.

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