Information for professionals

 
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SECTION FOR PROFESSIONALS IN THE TREATMENT OF OBESITY AND OTHER EATING DISORDERS

Professional Bariatric History

Sample file to be used as a guide for professional in the treatment of obesity.

Part (I)

PERSONAL DATA

Name:  
Address:  
Phone numbers:  
Date of birth:  
Age:  
Gender:  
Marital status:  
Nationality:  
Religion:  
Schooling:  
Occupation:  
Place of employment:  
Work itinerary:  
Name of husband or wife:  
Age:  
Name and age of children:  
   
   
   

 

ANTROPOMETRIC DATA

Size (inches):
Weight:

Somatotype:

M:

Ectomorphic

Mesomorphic

Endomorphic

F:

Hypofeminoid Feminoid Hyperfeminoid

Measures: 

Name of the person who took
the measures:

Biacromial diameter:
Biiliaco diameter:
Bitrocanterico diameter:
Neck circunference:
Torax/chest circunference:
Diaphragmatic zone circunference:
Waist circunference:
Hip circunference:
Thigs circunference:
Thoghs circunference:
Crochs circunference:
Knees circunference:
Calves circunference:
Forearms circunference:
Wrists circunference:
Skin folds:
Biceps:
Triceps:
Scapular:
Iiliac:

Total:

Body Mass Index:

Waist/hip index:
Body fat proportion:

Method used:

Body lean proportion:

Method used:

NEXT: SAMPLE PROFESSIONAL FILE PART II


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Dear visitor: The object of this web site is to inform and educate. Therefore, the information contained herein does not substitute professional medical attention.
If you have any doubt with respect to this information consult your personal doctor.

Medical supervision by Dr. Arieh Goldberg Kalik.
Bariatric physician, certified medical nutrition specialist. Certificate # 1010084

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