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Name(Required)

First Last

Consent(Required)

I allow Lonestar Bariatrics to use the information below on the website and other social media platforms

Pre-Surgery Weight(Required)

Post-Surgery Weight(Required)

Surgery(Required)

1. How did you hear about LoneStar Bariatrics?(Required)

2. Tell us about how your physical health and / or mental health has improved.(Required)

3. What are you able to do since you’ve lost weight that you couldn’t do before surgery?

4. Total Weight Lost - How much weight did you lose in the first 3 months post-surgery? 6 months? A year?(Required)

5. What was your overall impression of Dr. Carlton and his staff?(Required)

6. Additional comments you would like to share. (optional)

7. Before and After Photos(Required)

Before/After Photos you would like to share – please send in original format no pic collage or cut pics:

Drop files here or

Max. file size: 256 MB.

8. Videos

Videos you would like to share – if you want to video yourself answering the questions above – our marketing team will work their magic and compile (optional):

Drop files here or

Max. file size: 256 MB.

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Share Your Story

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Waxahachie Location

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