Name: Orlistat Weight Management - Online Prescriptions | Affordable, Quick, Easy - Online Doctor South Africa
SKU: odsa_94YNNZI
Price: 250.00 ZAR
Availability: InStock

Orlistat Weight Management

Details Required
Patient Info
Payment

Date

Time

First Name

Last Name

Contact Number

ID Number

Date Of Birth

Have you used our services before?

Yes

Address

Address Line 1

Address Line 2

City

Province

Postal Code

Country

Please provide your current weight in kgs (kilograms)

Please provide you height in cm (centimetres)

Your BMI is:

⛔ Please do not proceed. Based on your BMI, you are ineligible to receive a prescription for Ozempic.

Please click here to WhatsApp our Online Doctors for an instant consultation. They will advise on a treatment route that will suit you personally.

Have you used any weight loss treatments previously?

Yes

What medication or treatments have you previously used?

Are you pregnant or breastfeeding?

Pregnant

Breastfeeding

Not applicable

⛔ Please Do not proceed, this condition will disqualify you from receiving a prescription.
Please click here to WhatsApp our On Call Doctors for an instant consultation. The doctor will advise on a treatment route that will suit you personally.

When did you first notice your increased weight?

Do you have a history of any of the following?

Gastritis

Diabetes

Heart palpitations

High blood pressure

Glaucoma

Heart Disease

Kidney Disease

Liver Disease

Pancreatic Disease

Gallbladder Disease

Epilepsy

Urinary obstruction

Stroke

Cancer/Tumours

Neurological issues

Palpitations

Pulmonary artery hypertension

Thyroid disease

Chronic malabsorption syndrome

Cholestasis

None of the above

Do you have a history of any mental health issues?

Eating disorder e.g. anorexia or bulimia? ⛔(do not proceed)

Depression

Anxiety

Bipolar Disorder

Other

None of the above

What mental health issue or disorder do you have?

Do you have any other medical conditions?

Yes

What medical conditions do you have?

Are you taking any of these medications?

Cyclosporin

Acarbose

Amiodarone

Epilepsy medication

Blood thinners including Warfarin

Antiretrovirals (HIV medication)

Levothyroxine [Please take the Orlistat and Levothyroxine at different times (4 hours apart)]

None of the above

Are you currently taking any other medication?

Yes

What medication are you taking?

Do you have any allergies including allergies to medication?

Yes

What allergies do you have?

Have you had any medical workup done for your weight issue?

Yes

What medical workup/investigations were done and what were the results?

Weight loss medication will only be effective when part of a proper diet and exercise plan. Would you like to be referred to our partner telemedicine dietitians?

Yes

I am already seeing a dietitian

Please upload a recent full body photo of yourself (with clothes and without showing your face), for our doctors to properly assess you. **Edited, AI generated or unreal photos will not be accepted.

Choose Image

I have read and agree to the Terms and Conditions and Privacy Policy (POPI) of the use of this Website and Service.

Weight loss medication is only effective when used in conjunction with a proper diet and exercise plan. There is no guarantee of weight loss when using this medication.
I understand that submitting any inaccurate or false information could potentially be dangerous to my health and safety.
Treatment is prescribed as per South African medical guidelines. There is no guarantee that the treatment will be 100% effective for you. Please consult with our online doctors or visit an in-person doctor if you are still symptomatic or not improving.
I understand the questions above and have answered honestly. I understand that any inaccurate or false information could potentially be dangerous to my health and safety.
The medication that is prescribed is for my personal use only. I understand the side effects and effectiveness of the treatments.
This clinical form is to request a 3 month prescription of Orlistat only.
I agree to the Terms & Conditions of this platform.
I am 18 years or older.
I am currently living in South Africa.

I Agree to the terms and conditions of this Prescription Application and that of the use of this service.

Prescription

Price: R250.00

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If you require an invoice for medical aid, please fill out the below

Medical Scheme (Medical aid name)

Membership Number

Dependent Code

ICD 10 Code (DO NOT EDIT)

Submitting this questionnaire with any “⛔ (do not proceed)” conditions will disqualify you from receiving a prescription.

Please urgently visit your nearest emergency dept or in-person doctor if you are experiencing symptoms such as severe pain, chest pain, difficulty breathing, allergic reactions, dizziness, weakness, or other severe symptoms. Telemedicine services are not suitable for emergency medical conditions.

Orlistat Weight Management

Orlistat is a medication for weight loss designed to treat obesity by preventing the absorption of fats from the diet, thereby reducing caloric intake. It works by inhibiting an enzyme that breaks down fats in the intestine. As a result, undigested fats are excreted from the body.

test kits available

Orlistat Weight Management

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