Review Your Answers

What ethnicity are you?

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What sex were you assigned at birth?

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What is your Date of Birth?

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What is your height & weight?

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Have you been diagnosed with diabetes?

*Answer*

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Do you suffer from any of the following?

*Answer*

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Please list any other medical conditions you have

*Answer*

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Do any of the following statements apply to you?

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Have you ever used any other medications to aid in weight loss?

*Answer*

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Please indicate whether you are presently using any medication, such as prescription drugs, over-the-counter medications, or supplements, by selecting all that are applicable to you.

*Answer*

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Have you taken Mounjaro, Ozempic, Rybelsus, Wegovy or Saxenda medication in the past 28 days?

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Do you have any known allergies?

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Share with GP?

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I confirm that i have reviewed my answer and answered honestly

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