Weight Management Form

Patients at Civic Medical Centre will receive an invite for a Weight Management Referral if they are 18 years old or over, and also have a recorded BMI of 30 or more (or 27.5 or more for people from black, Asian, and ethnic minority backgrounds, who are at an increased risk of some conditions at a lower BMI, such as type 2 diabetes).

Please do not complete the form if you have not received an invite via SMS text message, email, or letter.

If a patient does not reply within 21 days we will assume they do not want a Weight Management Referral and update their record appropriately.

Patients who decline a referral will be able to contact the surgery if they change their mind.

IMPORTANT: THIS IS NOT A REFERRAL FOR WEIGHT LOSS INJECTIONS.