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Instructions and Required Forms

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Weight Management Program


Contact Us

Weight Management Program
Metabolism, Endocrinology & Diabetes / Podiatry Clinic

Domino's Farms, Lobby C, Suite 1300
4000 Ave Maria Drive (use for GPS and map programs)
Ann Arbor, MI 48105

Map and directions


Please note:

This is a clinical and research program with restricted admittance.  Patients must meet certain eligibility criteria. All patients must have a BMI ≥32 kg/m2 with a weight-related health condition (for example, high blood pressure or type 2 diabetes) or a BMI ≥ 35 kg/m2.  Please use this BMI chart to find your BMI or use a standard BMI calculator found on the Internet.


To apply for this program, please do the following:

1. Review the ORIENTATION to the Weight Management Program:  

          Orientation [Powerpoint]   OR    Orientation [PDF]

2. Then take this Self-Assessment QUIZ:

3. Record the confirmation number:

Please record the confirmation number that you receive after you have passed the self-assessment quiz, and provide this to the appointment scheduler to prove that you reviewed the orientation information and passed the quiz.

4. Complete the Initial Evaluation Form and the Questionnaires:


To inquire further, contact the study coordinator, Nicole Miller, MPH, RD, at or



(734) 647-5871 or 866-266-5221 (toll-free)