Are you a candidate for weight loss Injections?

Get your results instantly!

Complete our quick self-assessment to see if you may be eligible for medically supervised weight loss injections. Answer each question honestly to receive the most accurate, personalised result in seconds.

Press Enter

What is your height in centimeters?(Required)

Press Enter

What is your weight in kilograms?

Press Enter

Have you been diagnosed with any of the following conditions?(Required)

Type 2 Diabetes

High blood pressure

High cholesterol

Polycystic Ovary Syndrome (PCOS)

Obstructive sleep apnoea

None of the above

(Tick all that apply)

Press Enter

Do you have a history of any of the following?(Required)

Thyroid cancer (medullary) or family history of it

Multiple Endocrine Neoplasia Syndrome Type 2

Eating disorders (anorexia, bulimia)

Severe gastrointestinal disease

None of the above

(Tick all that apply)

Press Enter

Are you currently pregnant or breastfeeding(Required)

Yes

Not Sure

Press Enter

Have you tried to lose weight through diet and exercise in the past 6 months?(Required)

Yes, with limited success

Yes, and it worked

Press Enter

What is your full name?(Required)

First Last

Press Enter

What is your phone number?

Press Enter

What is your email address?(Required)

Press Enter

What is your main motivation for seeking weight loss treatment?

Press Enter

Consent(Required)

I consent to The Canmore Clinic processing my information in line with the privacy policy.

Press Enter

0% Completed!

Privacy Policy
Terms & Conditions
Cookie Policy
Complaints Policy