Fylde Clinic · Repeat consultation

Weight Loss Oral Consultation Form

Weight loss Tablets Consultation Form

Fylde ClinicStep 1 of 10 — 10% complete

Clinical Assessment

Weight loss Tablets Consultation Form

Clinically reviewedSecure & confidentialTakes 5–10 minutes

1Getting Started

Are you currently using any weight loss injections Mounjaro or Wegovy?*

Yes

Please upload your full body picture. (Kindly upload the most recent picture of yourself in tight clothes as shown in the e.g.)*

Click to upload

PNG, JPG, PDF up to 10MB

Please upload your picture ID Proof (Driving License/ Passport) for Verification.*

Click to upload

PNG, JPG, PDF up to 10MB

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