WeightLossReview – Dickson Chemist

It’s time for a review – we will ask you to do these once a month for the first 3 months, then every 3 months.

We need to do this as the law requires that we record how you are getting on and allows us to intervene if there are any problems.

The first 3 are included in your original consultation fee. A repeat prescription for long term use of Mounjaro then costs £30 for 3 months, or £55 for 6 months prescription.

You are going to need a picture of you in front of a mirror again (like we did before) and a picture of your weight with you standing on a scale. So don’t proceed until you are ready to do this for us!

Name

Your full name as it appears on your ID

Date of birth

Email

(A copy of this consultation is emailed to you)

Phone Number (mobile is best)

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Results!

Lets get your current weight and BMI recorded.

Unit of measurement

detail us! were

BMI

How much weight have you lost since you last did a review, or started the medicine?

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Now for the evidence!

In order to comply with UK legislation, we need evidence of your weight. Please take a picture of you standing on a weighing scale – where we can clearly see the numbers on the scale. If you don’t have a scale, then a picture of a printout from a commercial weighing machine, or weight taken at a doctors visit will do!

A picture of you standing on a scale or equivalent

Click or drag a file to this area to upload.

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Get your smile on 🙂

We need a full length picture of you – standing straight upright. In a mirror – or get your friend to do it for you.

Say Cheese! Upload a full length picture of you!

Click or drag a file to this area to upload.

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Now for the good stuff

This is where you let us know how you are getting on.

Have you had any bruising or infections at the injection site?

Yes
No

Have you been taking the medicine regularly as prescribed?

Yes
No

If NO let us know what happened in as much detail as you can

Have you had any reactions to the medicine that were unexpected?

Yes
No

If YES let us know what happened in as much detail as you can

Please confirm that (if it is appropriate) you are using precautions to prevent pregnancy. This medicine may be harmful to unborn babies

Yes
No
Not Applicable

Now we need to ask you to watch a video and read some information. In very rare cases, patients taking Mounjaro or similar have developed acute pancreatitis. This is an extremely rare side effect, but we want to make sure you know what it looks like.

Click here to watch a video on the symptoms of pancreatitis – a rare side effect of GLP-1 medicines

Please click here to review the NHS Inform guide to symptoms of acute pancreatitis.

I have read and understood the symptoms to watch out for and if I develop them will go to hospital immediately.

Yes

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Your ongoing therapy

Nearly there!

Which dose were you taking last month

I am happy to continue therapy with Mounjaro

Yes
No

Which dose would you like to continue with – you can go up or down by one step from the previous month, more isn't always more – if you are losing weight on the current dose still, then we recommend staying at the same dose. If your weight loss has significantly slowed, then go up a dose. Changes to your dose may require one of our prescribers to call you, so if the phone rings – it's maybe us! (It might be from an unknown number).

How many months would you like prescribed (if it is in the first 3 months you can only choose 1) otherwise you can choose 3 or 6 months, you can buy these monthly – you are not committed to buying these once they are prescribed

1
3
6

I also need pen tips for the needles (you get 1 box a year free)

YES
NO

Please send me more cleaning skin wipes (6 boxes a year included free)

YES
NO