SLIM/WELL

  • CONFIDENTIAL CLIENT INFORMATION

  • PERSONAL INFORMATION

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  • METRICS

  • AGENT

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  • MEDICAL QUESTIONNAIRE

    CONDITIONS (PLEASE NOTE TO SELECT ALL CONDITIONS CURRENTLY EXPERIENCED OR IN THE PAST)

  • Other weight management protocols

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  • SURGICAL & MEDICAL

    SUGRICAL/MEDICAL HISTORY & MEDICATION

  • EXAMPLES OF MEDICATIONS

  • Examples may include: blood pressure medication, insulin, thyroid medication, hormonal therapy, vitamins, supplements, Panado, or over-the-counter weight aids.

  • INFORMED CONSENT AND INDEMNITY

    TERMS & CONDITIONS

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  • POPIA & Client Rights

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  • Health Risks & Responsibility

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  • Product Nature & Disclaimers

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  • Contraindications

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  • Indemnity & Assumption of Risk

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  • Consent to Participate

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