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Menopause
About Megan
Contact
Make Appointment
Medical weight loss follow-up
Step
1
of
6
16%
First, let's start with some basics
We'll use this to verify your details.
Name
(Required)
First
Last
Date of Birth
(Required)
Day
Month
Year
Phone
(Required)
Email
(Required)
Enter Email
Confirm Email
Have you previously had a consultation with Dr Megan Young?
(Required)
Yes
No
This booking form is for clients who have previously consulted with Dr Megan Young.
Let's check in on your progress (optional)
This is optional, but it's useful to get an idea of your progress ahead of your follow-up appointment.
Please enter your weight (kg)
Try to be as accurate as possible
Please enter your height (cm)
Try to be as accurate as possible
Estimated BMI
Based on your answers above.
Let's check in on your progress (optional)
This is optional, but it's useful to get an idea of your progress ahead of your follow-up appointment.
Have you experienced any of these side effects while taking your weight loss medication?
Nausea
Diarrhoea
Stomach (abdominal) pain
Vomiting
Constipation
Other
Please describe the other side effect(s)
How severe would you rate these side effects?
Barely noticeable
Mild
Manageable
Unmanageable
Severe
Have you noticed any changes to your general mood while taking your weight loss medication?
No change
Feeling happier
Feeling less happy
Have you noticed any other mood changes while taking your weight loss medication?
Yes
No
Can you describe your mood changes?
Are there any specific issues you would like to raise during your follow-up appointment?
Record keeping
This is just to make sure your information is all up to date.
Has your address changed since your last appointment?
Yes
No
Please enter your new address:
Street Address
Address Line 2
City
State
Zip Code
Have your Medicare details changed since your last appointment?
Yes
No
Medicare card number
The full 10 digit Medicare number at the top of your card
Individual Reference Number
This is the number next to your name
Expiry
The expiry/valid to date
Let's make a time!
Please select a time that suits you. Your appointment will take around 10 minutes.
Booking form
(Required)
Confirm and payment
We're almost there! Please select your payment method to confirm your booking.
Product Name
Follow-up appointment (non bulk-billed)
Total
Credit Card
(Required)
Do not close your browser while the payment is being processed.
Phone
This field is for validation purposes and should be left unchanged.
