Medical Assessment Weight Loss Consultation Prioritize your health with our medication consultation for safe weight loss options like Mounjaro, Wegovy or Orlistat, Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 4About YouFull Name *FirstLastDate of Birth *Email *Phone *Weight AssessmentHeight: * cm feet Weight: * kg stones NextYour HealthDo you suffer from diabetes, heart disease, high blood pressure or high cholesterol? *YesNoAre you allergic to Orlistat, Wegovy or Mounjaro? *YesNoWe are unable to supply you with medication for weight loss. Please consult your GP or doctor. Are you pregnant or breastfeeding or intending to become pregnant or start breastfeeding whilst taking medication? *YesNoWe are unable to supply you with medication for weight loss. Please consult your GP or doctor. Have you been diagnosed with any of the following? *YesNo Problems absorbing food (chronic malabsorption syndrome) diagnosed by a GP Liver problems Kidney problems Thyroid problems Surgery to remove your gallbladder (cholecystectomy) Cholestasis (condition where the flow of bile from the liver is blocked) Any serious medical condition which may require immediate hospitalisation We are unable to supply you with medication for weight loss. Please consult your GP or doctor. Have you ever suffered from an eating disorder such as Anorexia Nervosa or Bulimia? *YesNoWe are unable to supply you with medication for weight loss. Please consult your GP or doctor. Please upload a FULL body image of yourself which also shows your face. * Click or drag a file to this area to upload. PLEASE NOTE - ANY MISSED PICTURES WILL DELAY YOUR ORDER. All pictures are sent secure, confidential and are only seen by the clinical team. If for any religious or any other reason you do not want to show your face, please let us know and we can arrange a video call instead.NextYour MedicationAre you currently taking any over-the-counter or prescription medication or any recreational drugs? *YesNoAre you taking any of the following medications? *YesNo Other weight loss treatments HIV medication Fat-soluble vitamins Oral anticoagulant drugs used to thin the blood such as Warfarin Ciclosporin (used after organ transplants, for severe rheumatoid arthritis and some severe skin conditions) Thyroid Medicine (levothyroxine) Iodine salts Amiodarone (used for heart rhythm problems) Acarbose (an anti-diabetic drug used to treat type 2 diabetes mellitus) Anticonvulsant/anti-epileptic drugs Antidepressants Antipsychotics including lithium Benzodiazepines including diazepam We are unable to supply you with medication for weight loss. Please consult your GP or doctor. Are you taking any medicine for high cholesterol, diabetes or high blood pressure? *YesNoYou must speak to your GP or doctor to discuss the dosage of your medicine when your weight changes. Are you using an oral contraceptive? *YesNoYou must speak to your GP or doctor to discuss the dosage of your medicine when your weight changes. NextAgreementDo you understand that the treatment must be stopped once your BMI goes below 28? *YesNo You must agree to this before continuing. If you need assistance, please contact our customer support. Do you understand that treatment cannot be continued if you gain weight 3 months after starting the treatment? *YesNo You must agree to this before continuing. If you need assistance, please contact our customer support. Do you understand that you should take a multivitamin that contains vitamins D, E, and K and beta carotene? It should be taken once a day at least 2 hours before or after taking Orlistat (Xenical/Alli/Orlos) such as at bedtime. *YesNo You must agree to this before continuing. If you need assistance, please contact our customer support. Do you understand the treatment should be taken with a nutritionally balanced, calorie-controlled diet that contains approximately 30% of the calories from fat? It is recommended that your diet is rich in fruit and vegetables. *YesNo You must agree to this before continuing. If you need assistance, please contact our customer support. Do you agree to the following? *YesNo You will read the patient information leaflet supplied with your medication You will contact us and inform your GP of your medication if you experience any side effects of treatment, you start new medication and/or your medical conditions change during treatment The treatment is solely for your own use You have answered all the above questions accurately and truthfully You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health You understand that whilst decisions relating to your treatment are made jointly between you and the prescriber, the final decision to issue a prescription will always be with the prescriber You must agree to this before continuing. If you need assistance, please contact our customer support. I agree to the Terms & Conditions and Privacy Policy *I agreePlease read these Terms and Conditions carefully before using our website drugs4delivery.com, associated applications, and services operated by Drugs4Delivery. 1. Acceptance of Terms By accessing and using our services, you agree to be bound by these Terms and Conditions, all applicable laws and regulations, and agree that you are responsible for compliance with any applicable local laws. If you do not agree with any of these terms, you are prohibited from using or accessing this site. 2. Privacy Your privacy is very important to us. Our Privacy Policy, which also governs your visit to our site, can help you understand how we collect and use your personal information. Please read it here: Privacy Policy. 3. Use License Permission is granted to temporarily download one copy of the materials (information or software) on Drugs4Delivery’s website for personal, non-commercial transitory viewing only. This is the grant of a license, not a transfer of title, and under this license, you may not: Modify or copy the materials; Use the materials for any commercial purpose, or for any public display (commercial or non-commercial); Attempt to decompile or reverse engineer any software contained on Drugs4Delivery’s website; Remove any copyright or other proprietary notations from the materials; or Transfer the materials to another person or “mirror” the materials on any other server. 4. Disclaimer The materials on Drugs4Delivery’s website are provided on an ‘as is’ basis. Drugs4Delivery makes no warranties, expressed or implied, and hereby disclaims and negates all other warranties including, without limitation, implied warranties or conditions of merchantability, fitness for a particular purpose, or non-infringement of intellectual property or other violation of rights. 5. 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The inclusion of any link does not imply endorsement by Drugs4Delivery of the site. Use of any such linked website is at the user’s own risk. 8. Modifications Drugs4Delivery may revise these terms of service for its website at any time without notice. By using this website, you are agreeing to be bound by the current version of these Terms and Conditions. 9. Governing Law These terms and conditions are governed by and construed in accordance with the laws of [Jurisdiction] and you irrevocably submit to the exclusive jurisdiction of the courts in that location. 10. Contact Us If you have any questions or concerns about these Terms and Conditions, please contact us by e‑mail at info@drugs4delivery.com or phone at 01472 241990. We are committed to protecting and respecting your privacy. This Privacy Policy outlines how we handle, store, and protect your personal data when you use our website drugs4delivery.com, associated applications, and services. Information We Collect We may collect and process the following data about you: Personal Information: Your name, address, email address, telephone number, and other contact details. Health Information: Prescription details, medical history, and other health-related information necessary for us to provide you with our services. Transaction Data: Details about payments to and from you and other details of products and services you have purchased from us. Technical Data: Internet protocol (IP) address, your login data, browser type and version, time zone setting and location, browser plug-in types and versions, operating system and platform, and other technology on the devices you use to access this website. Usage Data: Information about how you use our website, products, and services. How We Use Your Information We use information held about you in the following ways: To Fulfil Our Services: To dispense and deliver prescriptions and other products. To Communicate With You: Responding to your inquiries, providing information about changes to our services, and handling customer service interactions. For Legal Obligations: Complying with regulatory and legal obligations. For Marketing Purposes: Providing you with promotional materials or communications regarding products and services that may be of interest to you, where you have consented to be contacted for such purposes. Data Protection We take the security of your data seriously. We have implemented appropriate technical and organizational measures to protect your personal data against unauthorized or unlawful processing, accidental loss, destruction, or damage. Sharing Your Information Service Providers: We may employ third-party companies and individuals to facilitate our service (e.g., payment processors, technology service providers). Legal Requirements: We may disclose your information where required by law or subpoena. Business Transfers: If we are involved in a merger, acquisition, or asset sale, your personal data may be transferred. Your Rights Under UK data protection law, you have rights including: Access: The right to ask for copies of your personal data. Rectification: The right to ask us to rectify information you think is inaccurate or complete information you think is incomplete. Erasure: The right to ask us to erase your personal data, under certain conditions. Restriction of Processing: The right to ask us to restrict the processing of your personal data, under certain conditions. Object to Processing: The right to object to the processing of your personal data, under certain conditions. Data Portability: The right to request that we transfer the data that we have collected to another organization, or directly to you, under certain conditions. Contact Us If you have any questions about this Privacy Policy or our privacy practices, please contact us by e‑mail at info@drugs4delivery.com or phone at 01472 241990.Submit