My Medical History - Form

Once you have completed this medical history form, your medical history can be viewed by your Doctor - but only AFTER you LINK profiles.

Your completed medical history forms can be viewed below.

Working with Your Existing Doctor

  • We recommend that you work with your current G.P. to be medically evaluated for your suitability (or otherwise) for a course of obesity medication for the treatment of weight managment.
  • Your current G.P. knows your full medical history and knows you personally for a considerable period of time.
  • For medical card holders – this is free.
  • You can link your 25BMI accounts with your current G.P. and he / she can manage your course of treatment through the 25BMI service.
  • If you link accounts, you give your express permission for your current G.P. to be able to view the information you submit in this form.
  • This will enable your G.P. to evaluate your suitability more efficiently and manage your progress.

 

Your Medical History

  • This form is for individuals who wish to be evaluated for their suitabaility for obesity medication for the treatment of weight management by their own doctor (G.P.).
  • Please complete this form in full, including your medical history.
  • You can then decide to share this information with your G.P. (or not).
  • Your personal medical history will never be shared with anyone without your express permission.

My Medical History - Completed Form(s)

Below please find your completed Medical History Form(s). Please click on the date-link to see all your infomation.

NameDate Medical History Form Completed

There is no information to display as you have not yet completed your 25BMI Medical History Form.

NameDate Medical History Form Completed