1. Weight Loss Surgery Psychological Evaluation

2. Why do I need a psychological evaluation? Surgery is stressful; we want to make sure you are ready for the challenge, both physically and emotionally Early identification of problems allows us to intervene and improve surgical outcomes Insurance companies require a psychological evaluation before they will approve your surgery Our surgeons need to know the answers to certain questions that can only be answered by psychologists who are trained to conduct bariatric surgery evaluations

3. What does the evaluation cover? Your lifestyle (e.g., sleep, exercise, smoking, drinking) Your understanding of lifestyle changes necessary to have a good outcome Your ability to cope with stress Your ability to follow a treatment regimen (diet, exercise, supplements) Your support network Any psychological issues that could effect your surgical outcome –Eating related problems (e.g., binge eating; sugar addiction) –Other psychological issues (e.g., depression, anxiety, alcohol abuse) Any concerns you may have about surgery or lifestyle changes

4. What happens if the psychologist finds a problem? The psychologist will explain your test findings to you The psychologist will help you to identify “options” to address the problem, either at St. Luke’s or by referring you to someone who is an expert in dealing with a particular issue Counseling and/or medication may be recommended Serious problems may delay your surgery until you are more stable Remember, the goal is for you to have the best possible outcome! –Matter of when, not if….

5. How long does the evaluation take? 3-4 hours 3 parts: –1 st part is done on computer over the internet –2 nd part (personality test) is done on a computer in the psychologist’s office prior to your interview –3 rd part is a face-to-face interview with a psychologist who is part of the St. Luke’s-Roosevelt Weight Loss Surgery Team Feedback is provided Recommendations are made Surgeon has report in 2-3 days Report required before decision to go ahead with surgery is made

6. What if this is for my child? We follow the same procedure Different tests are used that are appropriate for teens A family session is required to gather information from parents and to explain test results

7. How do I make an appointment? Visit our web site: –http://www.slrsurgery.org/assessments.html Read the BROCHURE to answer any questions you may have about the psychological evaluation When you are ready to take the tests call Cindy Fundora (212) 636- 1429. If unable to reach Cindy please call Pat Reilly (212) 523-2965 Cindy will give you a CODE that will allow you to take the online tests so that your privacy is protected Once you have your CODE, you may take the 4 tests whenever you like When you have completed all 4 tests, call Cindy (212) 636-1429 to schedule your interview with the psychologist Appointments generally are available within 2 weeks

8. How much does it cost? $300 CASH or CREDIT CARD at time of service If the patient is a child (under 18) there is an additional charge for a family interview ($180) We cannot except insurance as every carrier has different requirements and most providers are not on these panels However, we will gladly assist you in obtaining OUT OF NETWORK BENEFITS by providing you with a receipt and faxing your evaluation results to your insurance carrier (with your written permission) If you need (or would like) additional psychological services such as individual therapy, these services may be covered by your insurance or we will make a referral

9. Contacts Cindy Fundora(212) 636-1429 or CFundora@chpnet.org –To get your CODE –To schedule an appointment If unable to reach Cindy, call Pat Reilly at (212) 523-2965 PReilly@chpnet.org