Ambassador Opportunity Questionnaire

We want to hear about our patients’ weight loss journey with myBMI, and we would love to give you the chance for your story to be heard and appreciated! Please read the Terms & Conditions before completing the survey.

Name

What weight loss treatment are you undergoing?

What date did you start your treatment?

What was your starting weight (kg)?

What is your current weight (kg)?

What was/is your ideal weight goal (kg)?

Do you feel your weight loss journey has been successful?

Do you see any other benefits (apart from weight loss) from taking this treatment?

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?

Have you considered other weight loss medications? (if so, which one?)

Before Treatment Photo

After/During Treatment Photo

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

Ambassador Opportunity Questionnaire

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