____Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.12345678910111213141516171819202122232425262728What’s Your Birth Gender? *MaleFemaleNextWhat’s Your Date of Birth? *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920NextHave you used this service before? *I'M NEWIt's been more than 3 months since I've been hereI’m using Boots weight loss medicineNextAre you pregnant, planning pregnancy, or is there any possibility that be pregnant? *YesNoNextAre you Breast-Feeding? *YesNoNextDo you have any allergies? *YesNoNextDo you have any eating disorders, or have you had one in the past? *YesNoNextAre you currently dependent on chronic opiates or opiate agonists (e.g. methadone), or are you going through acute withdrawal (cold turkey)? *YesNoNextHave you been told by your doctor that you have an intolerance to lactose? *YesNoNextDo you have liver problems? *YesNoNextDo you have kidney problems? *YesNoNextDo you have a condition that causes seizures or do you have a history of seizures? *YesNoNextDo you have a current or past history of bipolar disorder? *YesNoNextDo you have a current or past history of depression? *YesNoNextDo you have any heart or circulation problems? *YesNoNextDo you have or have you ever had a condition affecting the circulation of blood in the brain? *YesNoNextDo you frequently use cocaine or other stimulants? *YesNoNextAre you usually a heavy drinker? *YesNoNextDo you have a medical condition or take medication that may contribute to your weight gain? *YesNoExamples include growth hormone deficiency, polycystic ovary syndrome, Cushing'sNextAre you currently taking any medication (over the counter or prescription)? *YesNoNextHave you ever had a serious head injury or head trauma? *YesNoNextHave you been told that you have chronic malabsorption syndrome? *YesNoNextHave you been told that you have cholestasis? *YesNoNext with Enter acute Have you been told that you have inflammatory bowel disease or any severe stomach or gut problem resulting in delayed stomach emptying (called gastroparesis)? *YesNoNextDo you have any problems with your pancreas? *YesNoNextEnter Your Height in CMs or Feets *Enter Your Weight in KGs or LBs *NextWHICH MEDICINE DO YOU PREFER?Consistency is key, That’s why we offer 10% off each time you re-order Weight Loss treatment. Please see our Terms and Conditions. Ultimately it will be a joint decision between you and one of our clinicians on whether a particular medicine is appropriate.Select Any *MounjaroWegovyXenicalNextPatients for whom no valid consent has been received. • Patients under 18 years or over 84 years of age. • Hypersensitivity to the active substance(s) or to any of the excipients or trace residuals in Mounjaro. See section 2 and 6.1 of the relevant Summary of Product Characteristics (SmPC). • Patients with an initial BMI < 27 kg/m2. • Patients with an initial BMI < 30 kg/m2 where no weight-related comorbidities are present. • Known or suspected pregnancy. • Breast-feeding individuals. • A confirmed anaphylactic reaction to any component of the Mounjaro injection. • Concurrent administration with another GLP-1 receptor agonist. • Patients already using another anti-obesity drug. • Patients with a current or previous diagnosis of an eating disorder. • Patients who require specialist weight management services. • Patients with poorly controlled diabetes mellitus. • Patients with severe gastrointestinal disease, including severe gastroparesis. • Patients with severe renal impairment or end stage renal disease. • Patients with severe hepatic impairment. • Patients with obesity secondary to endocrinological or eating disorders or to treatment with medicinal products that may cause weight gain. • Patients with pancreatitis. • Patients taking medications that would contraindicate the supply of Mounjaro. (see Product interactions). *Please confirm you understandSubmit