To help us understand that one or more of our treatment options are right for you, please answer the following questions. If you get stuck or need any help, you can contact us.

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Treatment can only be provided if your BMI is above 30. Alternatively, you must have a BMI of 27 or over and a health problem that can affect your weight such as high blood pressure, asthma or pre-diabetes.

Please select either Metric or Imperial measurements :

Metric (Centimetre and Kilograms)
Imperial (Feet and Pounds)

  • Diabetes/Prediabetes
  • High Blood Pressure
  • High Cholesterol
  • Asthma / COPD
  • PCOS
  • Obstructive sleep apnea
  • Low mood associated with your weight.

 

The presence of any of the above conditions means you might be suitable for treatment with a lower minimum BMI of 27.





To help us understand that one or more of our treatment options are right for you, please answer the following questions. If you get stuck or need any help, you can contact us.

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  • Acromegaly or any growth hormone problem
  • Chronic Malabsorption Syndrome
  • Cushings Syndrome
  • Gallbladder, Bile duct or Pancreas disease
  • Heart Failure
  • Kidney Disease
  • Liver Disease
  • Multiple Endocrine Neoplasia
  • Pancreatitis
  • Personal or Family History of Thyroid Cancer

If yes please provide details of:

  • Name of medicine
  • Strength
  • Date last dose taken

You may be required to provide evidence of your previous dose before we can prescribe a higher strength. This can be a photograph of the medicine box showing the label or alternatively please forward a copy of your previous confirmation email to verify@boltpharmacy.co.uk


Please include:

  • Name of medicine and strength.
  • Length of treatment.
  • When you took the last dose.
  • Reason for stopping if no longer taken.

Please note: Changes to eating patterns can affect the absorption of these medications. You should continue to take these medications according to your usual routine whilst using Mounjaro or Wegovy.


Acarbose, Alogliptan, Canagliflozin, Dapagliflozin, Empagliflozin, Ertugliflozin, Fenfluramine, Glibenclamide, Gliclazide, Glimepiride, Glipizide, Insulin, Linagliptin, Orlistat, Pioglitazone, Repaglinide, Saxagliptin, Sitagliptin, Somatrogon, Tolbutamide, Vidagliptin.


This includes over the counter, prescription or recreational drugs?




Please ensure you have read, understood and agree to the following information.

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Please see our FAQs page for more information.



  • To Inform both us and your GP about any treatment-related side effects, the initiation of new medication, or changes in your medical conditions during the course of treatment.
  • To read the patient information leaflet provided with your medication before using your new treatment. If you have any questions you can contact our support team or your GP.
  • The prescribed treatment is intended exclusively for your personal use.
  • You have provided accurate and truthful responses to all the preceding questions.
  • You acknowledge that our prescribers rely on your responses as truthful and honest to make prescribing decisions and recognise that inaccurate information may result in serious health risks.
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