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Choose the type of treatment you're looking for

What's your height?

What's your weight?

Have you been diagnosed with any of the following conditions?

These health conditions are often linked to weight, and may be improved with weight loss.

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What is your ethnicity?

We ask this because healthy weight ranges vary for different ethnic backgrounds.

Are you aged 18 to 74 years old?

Have you ever experienced an allergic reaction to any of the following medications?

Select all that apply.

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Are you currently pregnant, breastfeeding, or planning a pregnancy in the next 3 months?

GLP-1 medications should not be used during pregnancy or while breastfeeding.

Do you have, or have you ever had, any of the following conditions?

For your safety, it's important to tell us about your medical history.

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Have you been diagnosed with either thyroid disease, or liver disease or impairment?

Do you have any of the following gallbladder issues?

• Gallstones that have not been removed
• Blocked bile flow
• Gallbladder infection
• Gallbladder surgery in the past 12 months

Do you have, or have you ever had, any of these conditions?

It's important to tell us about your medical history.

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If you have type 2 diabetes, are you using insulin?

This treatment can affect insulin requirement and blood sugar regulation.

If you have type 2 diabetes, are you taking any oral or injectable medication (other than metformin and insulin)?

Are you currently taking any of the following medications?

• Amiodarone, Carbamazepine, Ciclosporin, Clozapine, Digoxin
• Fenfluramine, Lithium, Mycophenolate, Methotrexate
• Phenobarbital, Phenytoin, Tacrolimus, Theophylline, Warfarin

Are you currently a smoker?

Have you taken injectable weight loss medication in the last 6 months?

This can be with us or another provider.

Do you understand you may need to provide evidence of prescription if ordering a non-starter dose?

If sexually active, Mounjaro may reduce oral contraceptive effectiveness. Do you agree to use alternative contraception?

Do you agree to the following?

• The information I have provided is true and accurate
• I understand failure to give accurate information may result in refusal

Please check you understand this treatment information:

• I understand rapid weight loss can raise risk of pancreatitis and gallbladder issues
• I understand severe diarrhoea can reduce contraceptive effectiveness
• I will not combine with other weight loss medications
• I recognize these treatments may affect my mood

Final consent:

• Treatment is for my own use only
• I will read the patient information leaflet
• I will contact provider about side effects
• I agree to GP notification

I agree to my prescription being issued faster via the assisted prescribing service, if eligible.

(Optional)

I understand my data is processed as described in the privacy policy.

I agree to the Terms and Conditions and confirm I am over 18.