Assessment for Weight Loss

If yes, please list below.

• If you are a woman of child-bearing potential then you should use effective contraception during and for at least 2 months after stopping treatment
• Injectable weight loss medications should not be used by anyone trying to conceive, and that they should be stopped two months before trying to conceive
• Injectable weight loss injections on very rare occasions can cause pancreatitis and gallbladder related issues, and that I must stop treatment and seek urgent medical attention if I experience severe abdominal pain
• Injectable weight loss injections may lead to a worsening of mental health in some individuals and that I must stop treatment and contact my GP or 111 for further support should I experience this

• I agree to reading the patient information leaflet in full and will contact onlinemeds if I experience any side effects
• I confirm that the details I have provided are complete and accurate to the best of my knowledge
• I understand that the information I have provided will be used by the prescribers to determine whether supplying medication is appropriate
• I acknowledge that providing inaccurate information may lead to a refusal to supply medication or the supply of medication that may not be suitable
• I understand that onlinemeds are professionally required to notify my GP about any treatment prescribed to me