Patient Eligibility Assessment
Complete this quick questionnaire to check your eligibility for our services.
1
Your Details
2
Services
3
Medical
4
Result
👤Your Details
Please provide your basic information to get started.
Please enter your first name
Please enter your last name
Please enter your date of birth
Please enter a valid email address
Please enter your phone number
Please select your state
Please enter your postcode
Please select your gender at birth
Please confirm your age
🎯Choose Your Services
Select all the services you're interested in. You can choose multiple options.
Please select at least one service
🏥Medical Eligibility
Please answer these questions honestly. Your safety is our priority.
Are you pregnant, breastfeeding, or trying to conceive?
Have you ever been diagnosed with any of the following?
Select all that apply, or select "None" if you have no history of these conditions.
Are you currently undergoing chemotherapy or radiation therapy?
Are you located in Australia?
⚖️ Weight Management Questions
Have you had a serious adverse reaction to weight-loss medication in the past?
⚡ Hormone Therapy Questions
Have you had hormone levels tested in the past 12 months?
🩹 Injury & Recovery Questions
Do you have a severe or acute injury requiring emergency care?
You're Eligible!
Great news. Based on your responses you're a suitable candidate. Redirecting you to your patient portal to book a consultation…
Let's Have a Chat
Based on your responses, we'd like to discuss your situation before booking. This helps us ensure we can provide you with the best care.
Reasons for review:
Please contact us at [email protected] and our team will be in touch to discuss your options.
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