Your Personal Details
Please kindly fill in your name, email and phone number. We need to know this
information so we can ask relevant clinical
questions, define our communication channels and recommend suitable treatments.
What is your date of birth?
Please select a
complete date of birth.
Please provide your height.
Please provide a
valid height.
Please provide your weight.
Select Weight Unit
Please
provide a valid weight.
When did you last check your weight?
Please
select a valid date.
What is your target weight for the next 12 months?
Please
select a valid target weight.
Please upload a full body picture of yourself.
We will only ask for this every 6 months. The picture will only be visible to you and
the doctor. We realise it’s inconvenient, but it’s for the safety of our patients,
and to prevent health risks in those who are vulnerable.
Tip: use a full length mirror
Maximum allowed file size is 10mb. You have selected: 0mb file size.
Please
upload a picture before proceeding.