Weight Loss Prescription Consultation

Disclaimer for Patients

Choosing Online Prescription Without Supervision

By opting to obtain a prescription without enrolling in our medically supervised weight loss programme, you acknowledge and accept full responsibility for managing your treatment independently.

Our online prescription service is most suitable for individuals who are already under a supervised weight loss programme and require a continuation of their medication. If you are starting treatment for the first time or have not been regularly monitored by a healthcare professional, we strongly recommend enrolling in a structured programme for safe and effective weight management.

Weight loss medications can have significant effects on your health, and without proper medical supervision, there is an increased risk of:

Incorrect usage or dosage adjustments that may impact effectiveness.
Undiagnosed underlying conditions that could make the medication unsuitable or unsafe.
Potential side effects and complications that may require medical intervention.
Interactions with other medications or pre-existing conditions.

We highly advise informing your GP or another qualified healthcare professional about your treatment and arranging regular check-ups to monitor your progress and overall health.

FFMC provides this service based on the assumption that you are making an informed decision and understand the importance of professional medical oversight. If at any point you experience adverse effects or concerns, we advise seeking medical attention immediately.

ALL WEIGHT LOSS PRESCRIPTIONS ARE PROCESSED WEEKLY ON THURSDAYS SESSION WITH OUR WEIGHT LOSS DOCTOR.

Consent & Personal Details

Please confirm and provide your details

I confirm that I am 18 years of age or older, using this service voluntarily and on my own behalf. Any treatment or advice provided is intended solely for my personal use. *

I Agree I Disagree

Disclaimer for Patients Choosing Online Prescription Without Supervision. *

I understand and choose to proceed I don't wish to proceed

Prescription Process

All prescriptions will be processed and delivered to you by Molloys Pharmacy. You will be contacted by Molloys Pharmacy about prescription payment and delivery process after approval. The delivery will be within 48hrs.

Name *

First Name

Last Name

Email *

Confirm Email *

Address *

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Personal Information & BMI

Health metrics and personal details

Date of Birth * dd-mm-yyyy

Phone Number *

Area Code

Phone Number

Please specify your gender *

Male Female

BMI Calculator *

Please enter accurate details

Height (cm)

Weight (kg)

What is your blood pressure range? *

Lifestyle

GP contact details and lifestyle habits

GP Phone Number

GP Email Address

Do you smoke? *

Excessive smoking consumption can increase the risk of serious health issues.

YES NO

How many per day?

Do you drink alcohol? *

Excessive alcohol consumption can increase the risk of serious health issues.

YES NO

How many units per week?

How many cups of coffee would you drink a day? *

Please give accurate information

How many cups of water would you drink a day? *

NB. It is very important to stay hydrated when taking this medication in order to reduce potential constipation

How many hours of sleep do you average each night? *

Lack of sleep can affect two important hunger hormones (ghrelin and leptin), making you feel hungry and increasing your appetite.

GDPR Consent & Payment

Data protection consent and checkout

GDPR Consent Form *

To assist with your care, we at FFMC need to collect personal data about you. This information will include details of your health and your treatments. We may also need to record additional information that while may not seem to relate directly to your health it would help in our treatment of you. Examples of this kind of information would include things like your age, gender, marital status, number of children you have, your nationality, your employment status, religion, prison sentences. Our policy is only to collect and record information about you that helps in your treatment.

Declaration

I understand my health information will be seen or shared only with medical and administrative staff involved in my care or where FFMC is required to do so by law.
I understand that for the purposes of my treatment administrative staff may have to access my health data. Reasons for this access would include the re-issuance of prescriptions, the opening of letters and recording of information from hospitals about me, downloading and saving in my file results from laboratories, typing of letters to hospitals and other similar health related issues.
I understand that all FFMC staff sign a confidentiality agreement that binds them not to disclose my details to any unauthorised persons not involved in my care.
I understand that any health data shared outside of the practice for the purposes of my health treatment will, normally, be limited to information related to a particular treatment and not my entire file.
I understand that my health data will be stored primarily on a secure database operated by a specialist company and I understand that the company is only allowed process my health data under FFMC instructions.
I understand the law provides that in certain instances personal health information can be disclosed, e.g. in the case of some infectious diseases.
I understand that FFMC will only release information to, for instance solicitors or insurance companies, at my express request.
I understand that I can withdraw consent for processing of my personal health data at any time.

GDPR Consent *

I confirm my consent I do not consent

Consultation Summary

Weight Loss Prescription Fee

Online Doctor Review + Prescription

€25.00

Your payment is processed securely via Stripe. We never store your card details.

Weight Loss Prescription