We need this so we can calculate your body mass index (BMI) accurately. If you don’t know this, please measure yourself before continuing. Please ensure that you add the correct figures as any false or inaccurate information may lead to severe illness and serious harm.

We need this so we can calculate your body mass index (BMI) accurately. If you don’t know this, please weigh yourself before continuing. Please ensure that you add the correct figures as any false or inaccurate information may lead to severe illness and serious harm.

<ul>
<li>Acromegaly or any growth hormone problem</li>
<li>Chronic Malabsorption Syndrome</li>
<li>Cushings Syndrome</li>
<li>Gallbladder, Bile duct or Pancreas disease</li>
<li>Gastric surgery (bariatric surgery)</li>
<li>Heart Failure</li>
<li>Hypoglycaemia</li>
<li>Kidney Disease</li>
<li>Liver Disease</li>
<li>Pancreatitis</li>
<li>Severe gastrointestinal disease (e.g. inflammatory bowel disease, ulcerative colitis, Crohn's disease)</li>
<li>Type 1 Diabetes</li>
</ul>

<ul>
<li>This is your first order of with Journey Health and you do not order the starter dose</li>
<li>Your last order with Journey Health was more than 8 weeks ago and you wish to order a higher strength</li>
</ul>

Please upload images of your front, back and sides. Our clinical team will review your images to verify your eligibility for the treatment.

You must let us know if your medical situation changes or if you start a different medication before beginning treatment with us. Just send us a message via your patient account.

Our clinical team will take your BMI and all of your medical history into consideration and may prescribe off-label when making a decision about treatment.

Prescribed weight loss medication is only effective alongside other important lifestyle changes. For example, eating a low calorie diet and increasing physical activity. If I don’t make these changes, I may lose less weight than expected (or none at all) and have to stop treatment altogether.

<ul>
<li>This medication is for my personal use only.</li>
<li>I understand and have answered the questions above honestly.</li>
<li>I understand the side effects and effectiveness of these treatment options. This includes any alternative options available.</li>
</ul>

I have read, understand and agree to Journey Health's terms and conditions and privacy and cookie policy.

Are you between the ages of 18 and 74?