Assessment for Weight Loss

• Do you understand that you must not become pregnant or impregnate someone while taking this medication due to risk to an unborn child?

• Do you understand that GLP-1 medications can reduce the effectiveness of the contraceptive pill and that an additional barrier method is required?

• Do you understand that diarrhoea or vomiting can further reduce pill effectiveness, that missed-pill guidance should be followed, and that condoms should be used and a non-oral contraceptive considered if symptoms persist?

• Do you understand that effective contraception must be used during treatment and for at least 2 months after stopping treatment if you are of child-bearing potential?

• Do you understand that a non-oral contraceptive or additional barrier method is required for 4 weeks after starting Mounjaro and for 4 weeks after each dose increase?

• Do you understand that Mounjaro or Wegovy must be stopped at least 2 months before trying to conceive?

Do you agree to stop this medicine and seek urgent medical advice if you notice any of the following symptoms? 

• Neck lumps or a hoarse voice while taking this medicine
• Any deterioration in your mental health, including thoughts of self-harm
• Severe abdominal pain, persistent vomiting, or jaundice (yellowing of the skin)
• Any other symptoms causing concern
  

• I confirm that the treatment is for my personal use only.
• I consent to my personal and medical information being used to assess my suitability for the prescribed medication.
• I confirm that all the answers I have provided above are accurate
• I acknowledge that providing inaccurate information may result in medication not being supplied or being unsuitable.
• I understand that my information will be kept confidential and used solely for the purpose of this assessment. 
• I confirm that I will read the patient information leaflet provided with this medicine before using it.
• I agree not to use other weight loss medication with the requested weight loss medicine
• I will contact my GP and inform MedsDoctor if I have any concerns or experience any side effects, start any new medication, or if my medical conditions change during treatment.
• I understand that MedsDoctor is professionally required to inform my GP of any treatment prescribed to me.
• I give permission for MedsDoctor to request additional medical information from my GP if required.
• I agree with MedsDoctor Terms & conditions 

All UK pharmacies supplying prescription weight-loss treatments are required to verify your weight before providing medication. This helps ensure your safety.

To do this, we will arrange a short 5-minute video call with one of our Pharmacists. After placing your order, we will contact you with instructions on how to join the call using FaceTime, WhatsApp Video, Google Meet, or Zoom.

Please confirm that you understand and are happy to proceed with this requirement.