Weight Mangement

Achieve your health goals with confidence through our medically and scientifically assisted weight loss program. Designed to prioritize your safety, our approach is fully individualized to meet your unique needs. Backed by cutting-edge research, we provide personalized plans that deliver real, sustainable results. Our expert medical team closely monitors your progress every step of the way, ensuring your journey is both effective and secure. Take the first step toward a healthier, happier you—transform your life with the guidance of trusted professionals.

Contact Us

What is your current weight?

What is your current height

Have you had any blood work done in the last 12 months?

Yes

No

Do you have any known allergies to medications?

Yes

No

Do you take any of the following medications?

Sulfonylureas (i.e. Gliclazide or glimepiride)

Insulin

Meglitinides

Furosemide (Lasix)

SSRIs (fluoxetine, citalopram sertraline, escitalopram)

None of the above

Do you have frequent or unexplained headaches?

Yes

No

No, but I think I may have one

Have you experienced any of the following?

History of heart attack or stroke

Uncontrolled high blood pressure

Irregular heartbeat or arrhythmia

Active cancer diagnosis

Current pregnancy or breastfeeding

None of the above

Do you have any urinary symptoms? (bladder leakage, incontinence, interrupted urine stream, etc.)

Yes

No

New Field:

Are you currently taking any weight loss medication?

Yes

No

No, but I have previously taken weight loss medication.

If you have previously taken weight loss medication, which medication did you take?

Do you regularly consume foods or beverages that can inhibit iron absorption (e.g., coffee, tea, dairy, whole grains)?

Have you ever had surgery for weight loss?

Gastric bypass

Gastric sleeve

Gastric balloon

Other

How have you tried to lose weight in the past?

How effective was this for losing weight?

How long have you had concerns with your body weight?

What do you hope to achieve by losing weight?

If yes, please specify

How much weight are you hoping to lose?

How many times per week do you exercise 30mins or more?

Do you currently have any illness or injuries that are limiting you from exercising?

If yes, please specify

Do you currently have any illness or injuries that you are seeing a medical practitioner for?

If yes, please explain:

Do you currently experience any of the following symptoms?

Persistent fatigue or low energy

Joint or back pain related to weight

Shortness of breath during physical activity

Difficulty sleeping or snoring

None of the above

Have you been diagnosed with any of the following conditions? (Check all that apply)

Type 2 Diabetes

Hypertension (High Blood Pressure)

Hyperlipidemia (High Cholesterol)

Sleep Apnea

Thyroid Disorders (e.g., Hypothyroidism, Hyperthyroidism)

PCOS (Polycystic Ovary Syndrome)

Cardiovascular Disease

None of the above

What was your most recent blood pressure reading

Do you smoke, vape, or use tobacco products?

Yes

No

If yes, how long have you smoked, vaped, or used tobacco products for?

5 years or less

5-10 years

10 years or more

Are you currently taking any medications or supplements? (Please list all, including over-the-counter medications):

Do you plan to become pregnant in the next year?

Are you committed to regular follow-up visits and adhering to a treatment plan?

Yes

No

Do you plan to become pregnant in the next year?

Do you have any questions for the healthcare team?

What is your full name?

What is your phone number?

What is your Alberta Health ID?

What is your email?

Please take a photo holding your driver license (face should be visible)

Upload File

New Field

Upload File

Please provide a photo wear gym clothing (Side view)

Upload File

Which weight loss medication are you hoping to start on?

Do you want your prescription delivered?

Yes

No

Weight Mangement

Contact Us

Company

Patient Portal