Medical Questionnaire

Providing essential information for your doctor about your lifestyle and health to support safe and effective weight loss in Dubai, and East Africa.

This medical questionnaire is designed to help us understand your unique needs and identify potential risk factors related to your body constitution, lifestyle, and any negative influences you may have experienced in the past. The information collected ensures that our team can recommend the safest and most effective weight loss treatments tailored to you.

Confidentiality:
All information you provide is strictly confidential and will only be reviewed by the surgeon, anesthesiologist, and patient coordinator. Your privacy and trust are of utmost importance to us.

Time Commitment:
The questionnaire will take approximately 10-15 minutes to complete. It includes questions about your medical history, current lifestyle habits, and any existing health conditions to help us create a personalized weight loss plan.

Save and Resume Option:
You can save the form at any time using the button at the bottom of the page and resume filling it out later at your convenience.

Completing this questionnaire is a crucial step toward achieving your weight loss goals in Kenya, Nairobi, and East Africa. Your safety and long-term success are our priorities. Thank you for taking the time to provide these details!