Weight Loss Surgery Video & Quiz

To start your weight loss surgery journey, we invite you to watch our video with Jeffrey DeSimone, MD, and Kenneth Cooper, DO, to learn if a bariatric procedure is right for you.

To view the video, complete the form below and press submit. You’ll be brought to a confirmation page that provides you with the password to access the video.

After watching the video, you MUST complete a short quiz at the end of the video to ensure you understand the basics of weight loss surgery. The quiz is not usually compatible with tablets or smartphones. It should be completed on a laptop computer.

If you receive a passing score on the quiz, one of our staff members will contact you to schedule a consultation appointment within several days. If your score is unsatisfactory, our program administrator, Colleen Cauley, will contact you to discuss the next steps.  If you have any questions, please call Colleen at 315-470-8974.

Request to View Crouse Bariatric Surgery Information Video

Complete this form to view the Crouse Bariatric Surgery Information Video. It is important that you contact your health insurance carrier BEFORE requesting to view our video to see if they have excluded weight loss (bariatric) surgery from your coverage.

"*" indicates required fields

Name*
Address*
Does your insurance cover bariatric (weight loss) surgery?*
Date of Birth*
Note: We need this information to set you up in our system should you elect to register for the procedure after learning about the Crouse Program. Having the birth date will allow us to schedule your first appointment faster.
Upon clicking submit below, you’ll be brought to a confirmation page that provides you with the password to access the video. There is no need to submit this form again.
This field is for validation purposes and should be left unchanged.