💡 Help: Approximate time to complete consultation: 2 minutes
Please provide your Height and Weight so we can calculate your BMI
Your BMI must be over 30 to qualify, or between 27-30 with at least one weight related comorbidity such as pre-diabetes, diabetes, hypertension, dyslipideamia or obstructive sleep apnoea.
Please select either Metric or Imperial measurements :
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💡 Help: Why do we ask this? Optimal Body Mass Index (BMI) ranges may vary based on an individual's ethnic background.
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💡 Help: Use the following as a guide: Low = Under 90/60, Normal = Between 90/60 and 140/90, High = Over 140/90
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💡 Help: Please tick all that apply
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💡 Help: Examples include growth hormone deficiency, polycystic ovary syndrome, Cushing's syndrome, hypothyroidism, hypothalamic damage (e.g. tumour, trauma, or surgery)
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💡 Help: Have you previously been on a course of any prescription treatments, such as:
Ozempic
Wegovy
Mounjaro
Orlistat
Xenical
Saxenda
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💡 Help: If you’re currently using a prescription weight loss treatment from another supplier, please upload an image of the medication box showing the label.
If you are not, then you can skip this question and press Continue
📎
Click to upload files or drag and drop
Max 5 files, 5MB each
Allowed: jpeg, png, gif
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💡 Help: Is there any chance of you being pregnant? If you are male, simply answer "No".
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💡 Help: One more step!
Before we approve your first order, we just need a short video check-in with one of our pharmacy team. This helps us confirm your details, answer any questions, and make sure your treatment is safe and tailored to you.
The call takes just a few minutes and can be booked from your dashboard after checkout. We’ll also email you a reminder.
Please confirm you understand that:
Your consultation will be reviewed once checkout is complete.
A short video check-in is required for your first order.
If treatment is not suitable, you will receive a full refund.
Please confirm you’re happy to proceed
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💡 Help: You're almost done! Do you agree to the following?
- I declare that I have answered all questions truthfully and to the best of my knowledge.
- I will read the Patient Information Leaflet before taking any prescribed medication.
- I will contact Cheterfield Delivery Pharmacy and inform my GP if I experience any side effects, start new medication, or if my medical conditions change during treatment.
- I understand that prescribers take my answers in good faith and base prescribing decisions accordingly, and that incorrect information can be hazardous to my health.
- I understand that this questionnaire forms part of a request to the prescriber, and that the final decision to prescribe rests with the prescriber.
- I consent to this consultation being used to assess my suitability for treatment.
- I understand that my medication may require cold storage and careful handling.
- I agree to the stated delivery terms and understand that medicines will be dispatched in line with storage and safety requirements.
- I agree to be contacted for a follow-up video call if required.
- I understand that I will only be charged if my consultation is approved and a prescription is issued.
- I understand that the clinician may access my NHS Summary Care Record to support safe prescribing, including information about my medications, allergies, and adverse reactions.
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