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Bari Banter Guest Form
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Name
*
Your answer
Instagram Handle
*
Your answer
Email
*
Your answer
Phone number
*
Your answer
Type of surgery
*
Choose
Sleeve
Bypass
Band
Revision surgery
Other
If Other, please specify
Your answer
Date of surgery
*
Your answer
Heaviest weight
Your answer
Current weight
Your answer
Did you have any complications?
Your answer
What have been some of your biggest challenges / successes in your first year?
Your answer
What have been some of your biggest challenges / successes in your second year?
Your answer
What have been some of your biggest challenges / successes in your third year?
Your answer
What were some of your goals going into surgery?
Your answer
Biggest fear leading into surgery?
Your answer
What has been your most valuable lesson learnt since starting your journey?
Your answer
Proudest moment so far?
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What was your why? (The reason you decided to have surgery)
Your answer
If you could go back and tell yourself one thing pre-surgery, what would it be?
Your answer
If you could change one thing about your journey, what would it be?
Your answer
What has been your biggest hurdle so far?
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Describe yourself in 3 words
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Your top tip
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What is next for you? What are your future goals?
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Top 5 things you would like to discuss about your journey
*
Your answer
Is there anything off limits?
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Who would you like to hear from next / what topics should we try to cover?
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