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Nutritionist

Online Consultation Form

This health form will be used by our partner pharmacy to assess your safety & suitability to use the medication.

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At the end of the form, you will have the option to pay now or you can wait & an invoice will arrive via email - it may go to junk mail / spam folder so please check those.

 

Please read all the information carefully and complete all fields. If you have NOT used the medication before, you will be prescribed the lowest / starting dose. If you have used the medication before, there is a section to upload your proof of usage. Failure to upload your proof will delay your order.

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If at any point you are unsure of anything, please contact us or book in for a telephone consultation.

Please enter your address. This will be the address your

item is shipped to. Please ensure it is correct.

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