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Weight Management ClinicPlease have this document filled out by your pharmacist or a medical professional. Name Date of birth Height Weight Blood pressure Signed Position Date Official stampVisit:
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How to fill out medically supervised weight loss

01
Schedule an appointment with a healthcare provider who specializes in medically supervised weight loss.
02
Discuss your medical history, current weight, and weight loss goals with the healthcare provider.
03
Undergo a physical exam and any necessary blood tests to assess your overall health and determine the best weight loss plan for you.
04
Follow the healthcare provider's recommendations for diet, exercise, and any prescribed medications or treatments.
05
Attend regular follow-up appointments to track your progress and make any necessary adjustments to your weight loss plan.

Who needs medically supervised weight loss?

01
Individuals who are significantly overweight or obese and have not been successful with other weight loss methods.
02
Individuals with obesity-related health conditions such as Type 2 diabetes, high blood pressure, or sleep apnea.
03
Individuals who may benefit from the added accountability and support of a healthcare provider in their weight loss journey.
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Medically supervised weight loss involves a healthcare professional overseeing a weight loss program for an individual to ensure safety and effectiveness.
Individuals who are participating in a medically supervised weight loss program are required to file the necessary documentation.
To fill out medically supervised weight loss, individuals must provide detailed information about their weight loss program and progress under the supervision of a healthcare professional.
The purpose of medically supervised weight loss is to help individuals achieve their weight loss goals in a safe and controlled manner with guidance from a healthcare professional.
Information such as starting weight, progress updates, any changes to the weight loss program, and any adverse reactions or side effects must be reported on medically supervised weight loss.
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