2. Have you ever had an allergic reaction to any medication?
3. Are you currently taking any of the following:
4. Have you ever been diagnosed with any of the following:
5. Have you or anyone in your immediate family every been diagnosed with :
6. Do you suffer from any of the following:
7. Have you ever had bariatric surgery ,e.g. gastric band or gastric bypass?
8. Do you consume more than 10 standard drinks of alcohol per week or more than 4 standard drinks on any one day?
9. Are you pregnant or are you actively trying to get pregnant now or in the next 6 months?
10. If you are a woman of reproductive age, you must use an appropriate method of contraception if prescribed medication.
11. Prescription of medication is decided on a case-by-case basis and is not guaranteed. The consulting doctor will determine whether or not it is clinically suitable for you.