- MMC Weight & Wellness Program
- 12 Andover Road
- Portland, ME 04102
- Phone (207) 661-6064 *NEW
- Fax (207) 253-6073
- Website: MMC Weight & Wellness Program
Information to Aid You in Referring Patients
If you are a MaineHealth provider, please enter the referral into EPIC. If not on EPIC, please mail or fax the following information.
- Referral for the evaluation and treatment of morbid obesity (ICD-9 278.01)
- Referral authorization # from the insurance company
- BMI (or most recent height and weight)
- All related diagnoses and comorbidites
- Previous attempts/duration of unsuccessful weight loss
- Demographic Information on the patient (DOB, address, phone number, insurance info)
- Most recent H&P including blood work and medicationsReferral for the evaluation and treatment of morbid obesity (ICD-9 278.01)
Smokers will be required to quit smoking and have a nicotine level drawn and sent to us before their first appointment.
First Step for Your Patients
View our online informational session. After watching the video, fill out a health history questionnaire at mmc.remedyehr.com.