Weight Management Form

Why we ask for this information

This form is the first step in assessing whether our weight management service is suitable for you.

We use the information provided to calculate your BMI and review your medical history, helping our pharmacist determine whether treatment is safe and appropriate.

In some cases, based on your answers, you may not need to complete the full form and we will guide you towards more suitable support.

How we use your information

We take your privacy seriously. The information you provide will be:

• Used only to assess your suitability for our weight management service and to provide care
• Reviewed by a qualified prescribing pharmacist as part of a clinical assessment
• Stored securely in line with UK data protection requirements
• Accessed only by authorised healthcare professionals
• Not shared with third parties unless required for your care or by law

You can read our full Privacy Policy here

Completing this form does not commit you to starting treatment or receiving medication.

We will review your information and contact you to confirm whether the service is suitable for you and to arrange a consultation if appropriate.