Weight Loss Treatment Pre-Assessment Form

Inclusion/Exclusion Criteria

Are you between the ages of 18 and 74?
Based on your age, you cannot be included in this program.
Do you suffer from prediabetes, diabetes, heart disease, high blood pressure, high cholesterol or obstructive sleep apnoea?

Weight

This Online GP assessment costs £25 which is non-refundable. The information you provide is crucial for your weight loss consultation and prescription if appropriate.

Please be honest with your answers and about your current medical conditions and medications as it helps our doctors prescribe effective medication and provide tailored advice. Make sure to read the medicinal information provided below before completing the assessment.

https://www.medicines.org.uk/emc/files/pil.15484.pdf

Unit of measurement *
cm
kg

BMI

Your BMI is [8511]. Based on the data you have submitted, you cannot be included in this program.

Underweight

Healthy

Overweight

Obese

This is a continuation of my ongoing weight loss treatment and there have been no changes to my medical condition.