Book a Consultation - Precision Weight Loss Management

Have you ever been diagnosed with the following conditions(Required)

Insulin dependant diabetes
Thyroid cancer diagnosis, personal or family or history
Pancreatic conditions

Yes

Are you pregnant, breastfeeding or trying to for a baby?(Required)

Yes

Unfortunately, you are currently ineligible.
However, our team can be in touch with alternative options.
Please let us know if this is something you would be interested in by clicking "Continue" below.
Thank you for your time in completing the short questionnaire.

Congratulations you are eligible for the Precision Weight Management Program.

Our Patient Journey

Select Title(Required)

First Name(Required)

Last Name(Required)

Date of Birth(Required)

DD slash MM slash YYYY

Gender(Required)

Male

Female

Email(Required)

Phone(Required)

What is your height in cm?(Required)

What is your current weight in kg?(Required)

What is your current waist size in cm?(Required)

What is your hip measurement in cm?(Required)

What is your ethnic background?(Required)

What is your address?(Required)

What is your Suburb?(Required)

What is your Post Code?(Required)

What is your State?(Required)

Do you have a Medicare Card?(Required)

Yes

What is your Medicare number (without spaces)?(Required)

Please ensure your Medicare number is correct

What is your Medicare IRN (Individual Reference Number)?(Required)

Please ensure your Medicare IRN is correct

What is your Medicare Expiry?(Required)

Month

Year

What is your Individual Healthcare Identifier (IDI) number (without spaces)?(Required)

if you do not have an IHI you can apply for one via this link get your IHI number

What weight loss methods have tried previously?(Required)

Have you ever taken a prescription weight loss medication?(Required)

Yes

What medications and doses are you currently taking?(Required)

Do you take a regular multi-vitamin?(Required)

Have you had any surgeries. If yes, what surgeries and were any specifically for weight management?(Required)

Have you ever been diagnosed with a medical condition?(Required)

Have you ever been diagnosed with the following conditions?

Insulin Dependent Diabetes(Required)

Yes

Thyroid condition(Required)

Yes

Pancreatic conditions(Required)

Yes

Eating Disorders(Required)

Yes

Renal conditions(Required)

Yes

Mental health disorders(Required)

Yes

Are you currently taking any medication or supplements?(Required)

Do you have any allergies?(Required)

Have you ever been found to have high blood sugar?(Required)

Is there a history of diabetes in your family?(Required)

Does your current weight negatively affect your mood?(Required)

Do you believe this negative mood makes it harder for you to lose weight?(Required)

Yes

Have you ever been diagnosed with a mental health condition?(Required)

Yes

If yes - How long ago?(Required)

Do you feel like you have a strong support network?(Required)

Thank you for completing our pre screening questions. Please click on submit to send your answers to our Doctors.On the next screen you can commence booking your appointment.

We appreciate your commitment to your weight loss journey. Please provide the following information so our team can be in touch

Select Title(Required)

First Name(Required)

Last Name(Required)

Date of Birth(Required)

DD slash MM slash YYYY

Gender(Required)

Male

Female

Email(Required)

Phone(Required)

By checking this box I consent to be contacted by Precision Weight Loss Management regarding alternative therapies available.(Required)

By checking this box I consent to be contacted by Precision Weight Loss Management regarding alternative therapies available.

Name

This field is for validation purposes and should be left unchanged.

Precision Weight Loss Management is leading the way in medical weight loss

Let's see if we are a good fit for you

Congratulations you are eligible for the Precision Weight Management Program.

We appreciate your commitment to your weight loss journey. Please provide the following information so our team can be in touch

About Precision Weight Solutions

Quick Links

Company

Follow Us

Precision Weight Loss Management is leading the way in medical weight loss

Let's see if we are a good fit for you

Congratulations you are eligible for the Precision Weight Management Program.

We appreciate your commitment to your weight loss journey. Please provide the following information so our team can be in touch

About Precision Weight Solutions

Quick Links

Company

Follow Us

Book Your Appointment Today!