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1. Are you currently located in Australia?

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2. Are you aware that your doctor will advise you on the best treatment strategy for your individual circumstances and in some instances, this may not involve medication?

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3. Have you ever used medication for weight loss in the past?

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4. Do you have a known brain tumour?

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5. Do you agree to upload a full-length photo of yourself for the doctor?

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6. Do you consent to upload a photo of yourself (selfie) holding a photo ID (a valid Passport or Licence)?

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7. Do you understand we do not prescribe phentermine (Duromine) through Telehealth consultations?

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8. Do you suffer from a condition called gastroparesis or delayed gastric emptying?

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9. Do you have epilepsy or a history of seizures?

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10. Have you ever had bariatric surgery (e.g. gastric band or gastric bypass)?

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11. Have you ever been diagnosed with bipolar disorder, major depression or experienced suicidal thinking?

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12. Have you or anyone in your immediate family ever been diagnosed with Multiple Endocrine Neoplasia Syndrome 2 (MEN2)?

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13. Are taking medicines called monoamine oxidase inhibitors (MAOIs) or have taken them in the last 14 days?

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14. Have you or anyone in your immediate family ever been diagnosed with medullary thyroid cancer?

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15. Have you ever been diagnosed with severe heart failure?

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16. Do you suffer from cardiovascular disease (e.g. heart disease, heart attack or irregular heartbeat), untreated high blood pressure, peripheral vascular disease, or have had a stroke?

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17. Do you consume more than 10 standard drinks of alcohol per week or more than 4 standard drinks on any one day?

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18. Have you ever been diagnosed with an eating disorder?

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19. If you are a woman of reproductive age, will you be sure to use an appropriate method of contraception while on a weight loss program?

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20. You may be ineligible for medication prescribed through our weight loss program if you have suffered from diseases with your pancreas, liver or kidneys.

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21. You may be ineligible for medication prescribed through our Weight Loss Program if you take insulin.

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22. At times, due to national shortage of Ozempic medication. If eligible, our doctors may recommend an alternative treatment to Ozempic. Do you acknowledge this?

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23. Are you pregnant or are you actively trying to get pregnant now or in the next 6 months?

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