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New Patient Forms

Erie Medical Weight Loss offers our patient form(s) online so they can be completed it in the convenience of your own home or office.

  • All forms are PDF files. You will need AdobeReader® to view them...
  • If you do not already have AdobeReader® installed on your computer, Click Here to download.
  • Download the necessary form(s), print them out and fill in the required information.
  • Fax us your printed and completed form(s) or bring it with you to your appointment.

New Patient Forms - Click Here to Download

weight loss

Lose 45 Pounds
in 45 Days

NEW PATIENT SPECIAL OFFER

New Patients Receive a
Complimentary Consultation!
Fill out the form below and a member of our team will contact your shortly.

Your Name (required)

Your Email (required)

Phone (required)

Appointment Date (required)

When would you like to come in? (required)
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“The hardest thing for me was giving up coffee. I wasn’t hungry, or cranky from dieting, because I wasn’t on a diet it was a life change!! My doctor is so impressed with the weight loss that I may be able to go off my BP medicine in December!”

- Roxanne

“I have struggled with yo-yo diets my whole life. This program works and is surprisingly easy to stick with. My energy level soared and seeing the weight drop every day made it easy to stick with the protocol.”

- Anonymous

“I was able to stick to the program, had energy, never felt terribly hungry and was thrilled to see the excess weight disappear. Holly was so friendly and empathetic to my progress.”

- L.R.V.

YOU CAN FIND US HERE

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Erie Medical Weight Loss
3901 Liberty Street Suite B
Erie, PA 16509
(814) 440-7466
Weight Loss Service
OFFICE HOURS
Monday9am - 5pm
Tuesday9am - 5pm
Wednesday9am - 5pm
Thursday9am - 5pm
Friday9am - 5pm
SaturdayClosed