The following form is for existing Dokta weight management patients to order repeat medication.
Please complete as fully as possible. Your prescription will be issued within 24 hours of receipt.
Enter your weight in Stones and Pounds, or Kilograms.
Click any good effects you've noticed from taking the medication.
Any side-effects noticed in the past 1 month
You will need to seek healthcare advice urgently if you answer Yes to any of the following questions:
Have you been diagnosed with any new medical problems or started on any regular medication since your last review?
Required section for women
In order to continue with treatment
Which medicine and dose are you taking NOW
Which medicine and dose would you like to REQUEST.
Please note that a clinician may get in touch to discuss any changes to your request.
How many pens do you want.
Only complete if you would like delivery to a different address to your home address
