NHS & Private Services Available

Weight Loss

Are you currently using any weight loss medication?
This includes tablets or injections that we’ve been prescribing for you, or ones you're getting from another provider.
Which weight loss medication are you currently taking?
Which type of treatment would you prefer?
Have you ever used weight loss medication?
When did you last use weight loss medication?
Which weight loss medication did you last use?
How would you describe your ethnic background? What’s considered a healthy weight can be different depending on your ethnic background. Tell us how you describe yourself so we can ensure you’re getting the right care.
What’s considered a healthy weight can be different depending on your ethnic background. Tell us how you describe yourself so we can ensure you’re getting the right care.
Do you have any of these conditions?
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What eating disorder have you had?
Do you have kidney disease?
This might include chronic kidney disease (CKD), polycystic kidneys or kidney failure.
If you know when your last kidney test was done and what the results were (creatinine and eGFR), please let us know to avoid delays with your request. We specifically want to know whether you have severe kidney disease or renal impairment.
Are you currently pregnant, breastfeeding, or trying to get pregnant?
What is your current situation?
Are there any other significant illnesses or medical conditions that you haven’t mentioned already? This could be a current or past condition.
Do you currently take any medication, or have you recently finished a course of medication, that you haven't mentioned already? This includes medication you take occasionally or in emergencies.
Are you allergic to any medicines or other substances? For example, peanuts, soya, or other medications (including weight loss medications you’ve previously used).
What allergies do you have?
Your GP | Are you currently registered with a UK GP practice?
We cannot prescribe this medication to you without your GP’s details. We need to let them know about your treatment to ensure you get the best level of care possible.
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What’s Your Birth Gender?
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Nationwide Delivery Service
Do you agree and consent to the following? You are completing this consultation for yourself and to the best of your knowledge. You will disclose any medical conditions, serious illnesses or operations you have had. You will disclose any prescription medications you are currently taking and agree to use only use one weight loss treatment at a time. You agree to our Terms & Conditions, Terms of Sale, and confirm that you have read our Privacy Policy. Your accurate and honest responses to this online questionnaire for weight loss treatment are crucial. Withholding or providing false information can severely harm your health and may result in life- threatening consequences. By filling out this questionnaire, you confirm that your responses are truthful and accurate, acknowledging the potential risks of misinformation.
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