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🎁 GIFT VOUCHERS 💝

BLEU
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Start Consultation

Please complete our detailed consultation questionnaire, and upon submission, our team will assess your responses to determine if you are a suitable candidate for the medication. Your cooperation and accurate information are crucial for this evaluation process.

Personal Details

First name

Last name

Birthday

Phone

Email

Street Address

Town

County

Post Code

Country

Which ethnicity are you? Healthy BMI ranges are different according to your ethnic background. *

Asian or Asian British

Black (Caribbean, African)

Mixed Ethnicities

Other ethnic group

White

What sex were you assigned at birth? *

Female

Male

Are you currently pregnant, trying to get pregnant, or breastfeeding? *

Yes

No

What is your current weight?

Weight unit *

kg

lbs/stone

What is your height?

Height unit *

cm

ft/in

Mon - Tues:

10AM - 6PM

Wed - Thur:

10AM - 8PM

Friday:

10AM - 6PM

Saturday:

10AM - 5PM

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