Ambassador Opportunity Questionnaire

We are looking for patients who are new to treatment and have opted for our new weight loss treatment bundles.

We would love to document and share your journey!

Name

What bundle have you started treatment with?

Starter Bundle (0.25mg, 0.5mg, 1mg) Step-Up Bundle (0.5mg, 1mg, 1.7mg)

What date did you start your treatment?

What was your starting weight (kg)?

What is your ideal weight goal (kg)?

Have you suffered from any side effects?

Can you describe the side effects (if any)?

Have you been successful in weight loss before taking this treatment?

Before Treatment Photo

Can you give us a message about your journey with myBMI so far?