Health Questionnaire

To assist us with your consultation please complete the following online form prior to your appointment.

Alternatively you can download a PDF of the form to complete manually here. Health Questionnaire


Medical Conditions

Do you have or have you ever had, the following conditions, please select “Yes” to any relevant condition.


Medical History

Your Privacy, Our Concern – Consent to use your personal information

Dr Ian Baxter and The Sunshine Coast Medical Weight Loss Centre complies with the Commonwealth Privacy Act and all other state and territory legislative requirements in relation to the management of personal information. We collect information that is necessary for the provision of your health care. Personal information obtained from you in your consultation may be used to provide information to various health services involved in supporting your health care management (e.g. pathology, radiology, hospitals or other specialists).

I have read and understood the Privacy Policy and understand my rights and responsibilities.

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