Kickstart your weight loss journey with the Allurion Gastric Balloon

Name *

Full Name

First Name

Last Name

Date of Birth *

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Phone *

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Address

Address 1

Address 2

City

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Would you like a phone or in-person consultation? *

Consultation costs $398, which is required to be prepaid. The good news is that this amount will be deducted from the total price of the Allurion package if you decide to proceed with the Allurion balloon. Alternatively, you may be able to claim this cost on your insurance policy. We look forward to supporting your journey!

Yes please I am ready

No I would like more information please

Do you have health insurance? *

Yes

No

Eligibility *

Please tick to confirm you are eligible for an Allurion balloon.

I am 18 years or older

I have NOT had stomach or weight loss surgery

BMI is 27 or higher

Have tried dieting with little success

I am Not Pregnant or Breastfeeding