Please help the WLSFA reach out to your Bariatric Surgeon’s office. Complete the form below to share who your surgeon is and allow the WLSFA to contact them on your behalf. We will let the office and doctor know you gave us permission to reach out to them to ask if they would support the mission of the WLSFA by referring patients to the WLSFA Grant program, donate funds or both!

PLEASE NOTE: Auto fill may not work properly on this form. 

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Medical Professionals and Industry Partners who support the WLSFA with Sponosrship dollars or donations of service to our grant program with be awarded the WLSFA Seal of Appreciation.  These seals are only alowed for use by our supporters.

If you have questions please contact the WLSFA


The WLSFA is a 501( C ) 3 Charity


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