Ordered with us before?

Enter Your Height

Enter Your Weight

Do you suffer from any of the following?

Prediabetes, diabetes, heart disease, high blood pressure, high cholesterol, or obstructive sleep apnoea

Providing your NHS number helps us securely access your medical records for a more informed review of your prescription history before dispatching your medication.

Are you between the ages of 18 and 74?

If you have type 2 diabetes, are you taking any injections or tablets to control your blood sugar, other than metformin?

Have you experienced an allergic reaction to Wegovy, Mounjaro, Rybelsus, or Semaglutide before?

Have you ever had an eating disorder?

Are you pregnant, breastfeeding, or planning to conceive?

Have you been diagnosed with or had surgery for any of the following conditions?

• Acromegaly or any growth hormone disorder
• Chronic malabsorption syndrome
• Cushing's syndrome
• Gallbladder, bile duct, or pancreas disease
• Gastric surgery (bariatric surgery)
• Heart failure
• Hypoglycaemia (low blood sugar)
• Kidney disease
• Liver disease
• Pancreatitis
• Severe gastrointestinal diseases, such as:
  • Inflammatory bowel disease (IBD)
  • Ulcerative colitis
  • Crohn’s disease
• Type 1 diabetes

Do you have a personal or family history of Medullary Thyroid Cancer (MTC), thyroid cancer, or Multiple Endocrine Neoplasia Type 2 (MEN2) syndrome?

Are you currently taking any medications, including prescription, over-the-counter, or recreational drugs?

Are you taking any of the following medications?

• Amiodarone
• Carbamazepine
• Ciclosporin
• Clozapine
• Digoxin
• Fenfluramine
• Lithium
• Oral Methotrexate
• Phenobarbital
• Phenytoin
• Somatrogon
• Tacrolimus
• Theophylline
• Warfarin

Are you taking steroids or any medication for your thyroid?

Have you used any weight loss medication, either injectable or oral, in the last 4 weeks?

Do you understand that you will need to provide evidence of a prescription from an alternative provider if any of the following apply to you?:

• This is your first order with InjectaHealth, and you are not ordering the starter dose.
• Your last order with InjectaHealth was more than 4 weeks ago, and you are requesting a higher strength.

Do you agree to the following?

• You will read the patient information leaflet provided with your medication.
• You will contact us and inform your GP if you experience any side effects, start new medication, or if your medical conditions change during treatment.
• The treatment is for your personal use only.
• You have answered all questions accurately and truthfully.

Do you understand that GLP-1 injectable weight loss medications (such as Mounjaro and Wegovy) may reduce the effectiveness of oral contraceptives, and that you should use additional non-oral contraception methods (e.g., condoms) during your treatment?

This medication should not be used by men or women who are trying to conceive or are within two months of starting to try for a child.

There may be an increased risk of pancreatitis, gallbladder problems, and gallstones with this medication. If you experience any abdominal pain while using this treatment, you should seek medical advice Injectable weight loss medications should not be used alongside other weight loss treatments.

Do you understand that injectable weight loss medications should not be used with other weight loss medications?

If you develop any lumps in the neck or experience a hoarse voice while taking this medication, you should stop the treatment and speak to your doctor.

Weight loss treatments, including injectable weight loss medications, have been associated with a lowering of mood. If you experience depression, thoughts of self-harm, or other mental health concerns, you should stop treatment and seek medical advice.

Final Confirmation

Before proceeding, please confirm the following options to finalise your submission: