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H.1494-0419 Weight Management

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What is your name, contact number and email address?
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Please tell us your age.
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Are you...
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What is your working status?  
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If applicable, what is your occupation? 
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Are your details currently registered with us? If you haven't, please do so here http://https://www.healthcareopinions.co.uk/
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How tall are you? 
Please anwser in imperial or metric 
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How much do you currently weigh?
Please anwser in imperial or metric and give best estimate of current weight.
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Have you gained or lost more than 10lbs (4.5kg) in the past 3 months?
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Have you tried to lose weight in the past by dieting? 
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Have you ever been diagnosed with any of the following? 
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Have you experience a stroke, transient ischemic attack or heart attack in past 6 months?
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Have you had liposuction within the past year?
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Have you ever had surgery for weight loss? 
For example, gastric bypass, stomach stapling, bariatric surgery
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How would you describe your ethnicity? 
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What is the highest level of education you have recieved?