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VLCD - Health Check Questionnaire

If your circumstances have changed please update your answers below:
A question highlighted red indicates the plan is not suitable and you will not be able to continue.

  Are you under 18 or over 75?  
 
  Are you pregnant, given birth in the last 12 weeks or breastfeeding?  
 
  Do you have an allergy to lactose, milk or soya?  
 
  Have you suffered severe trauma in the last 6 weeks?  
 
  Have you undergone minor surgery in the last 2 weeks?  
 
  Have you undergone major surgery in the last 12 weeks?  
 
  Do you have Type 1 diabetes?  
 
  Do you have liver or kidney disease or any other serious illness?  
 
  Do you suffer with any form of acute or chronic renal failure?  
 
  Do you suffer from porphyria?  
 
  Do you suffer from any psychotic illness?  
 
  Do you suffer with severe depression or bipolar disorder?  
 
  Do you have a serious heart condition?  
 
  Have you had a heart attack in the last 12 weeks?  
 
  Have you ever suffered with an eating disorder such as anorexia or bulimia nervosa?  
 
  Do you believe you have any health condition which you have not yet spoken to your doctor about?  
 
  Do you suffer from any form of epilepsy?  
 
  Have you checked with your doctor that a VLCD is suitable for you?  
 
  Have you read and agree to the Slim & Save Terms & Conditions, Privacy Policy and Allergen Policy ?  
 

You have either not completed the questionnaire or have made choices above which indicate you are not suitable to follow a VLCD programme. You will not be able to follow the Slim & Save programme or continue through checkout based on your answers.

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