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Weight Loss Assessment

A few quick questions so our doctors can tailor your plan.

Step 1 of

Thanks! Your assessment is in. Our doctors will review it and, once approved, your treatment will appear on your Treatments page.

If you don’t see your treatment on the Treatments page, try refreshing after a few moments.

Complete this step to continue.

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(select all that apply)","type":"checkbox","options":["Enhanced energy","Visible body composition changes","Better sleep","Faster recovery from training","Improved mental clarity","Reduced pain / inflammation"]}]},{"title":"Lifestyle","subtitle":"A few quick lifestyle questions.","fields":[{"name":"med_smoking","label":"Do you smoke or vape?","type":"radio","options":[{"label":"No","value":"no"},{"label":"Yes","value":"yes"},{"label":"Former smoker/vaper","value":"former"}],"required":true},{"name":"med_alcohol","label":"Do you consume alcohol?","type":"radio","options":[{"label":"No","value":"no"},{"label":"Yes","value":"yes"}],"required":true},{"name":"med_alcohol_frequency","label":"How many standard drinks per week?","type":"radio","options":[{"label":"1–3","value":"1_3"},{"label":"4–7","value":"4_7"},{"label":"8–14","value":"8_14"},{"label":"15+","value":"15_plus"}],"showIf":{"field":"med_alcohol","value":"yes"}},{"name":"mf_recreational_drugs","label":"Do you use any recreational drugs?","type":"radio","options":["Yes","No"],"required":true}]},{"title":"Activity & Exercise","subtitle":"How you move day to day.","fields":[{"name":"med_exercise_frequency","label":"How often do you exercise?","type":"radio","options":[{"label":"None","value":"none"},{"label":"1–2 sessions/week","value":"1_2"},{"label":"3–4 sessions/week","value":"3_4"},{"label":"5+ sessions/week","value":"5_plus"}],"required":true},{"name":"mf_exercise_types","label":"What types of exercise do you do? (select all that apply)","type":"checkbox","options":["Strength / Resistance","Cardio","Flexibility / Mobility","Mixed / Functional"]},{"name":"med_work_activity","label":"How active are you at work?","type":"radio","options":[{"label":"Sedentary","value":"sedentary"},{"label":"Lightly active","value":"lightly_active"},{"label":"Moderately active","value":"moderately_active"},{"label":"Highly physical","value":"highly_physical"}],"required":true}]},{"title":"Sleep & Recovery","subtitle":"How you're sleeping.","fields":[{"name":"med_sleep_hours","label":"How many hours do you sleep per night?","type":"radio","options":[{"label":"<5","value":"under_5"},{"label":"5–6","value":"5_6"},{"label":"6–7","value":"6_7"},{"label":"7–8","value":"7_8"},{"label":"8+","value":"8_plus"}],"required":true},{"name":"med_sleep_difficulties","label":"Do you have any difficulties with sleep? (select all that apply)","type":"checkbox","options":[{"label":"Falling asleep","value":"falling_asleep"},{"label":"Staying asleep","value":"staying_asleep"},{"label":"Early waking","value":"early_waking"},{"label":"Sleep feels unrefreshing","value":"unrefreshed"},{"label":"None","value":"none"}]},{"name":"mf_uses_sleep_aids","label":"Do you use any sleep aids?","type":"radio","options":["Yes","No"],"required":true}]},{"title":"Medicare / IHI Details","subtitle":"Your details are securely stored and only accessible to our clinical team. 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Energy Assessment

A few quick questions so our doctors can tailor your plan.

Step 1 of

Thanks! Your assessment is in. Our doctors will review it and, once approved, your treatment will appear on your Treatments page.

If you don’t see your treatment on the Treatments page, try refreshing after a few moments.

Complete this step to continue.

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(select all that apply)","type":"checkbox","options":[{"label":"Falling asleep","value":"falling_asleep"},{"label":"Staying asleep","value":"staying_asleep"},{"label":"Early waking","value":"early_waking"},{"label":"Sleep feels unrefreshing","value":"unrefreshed"},{"label":"None","value":"none"}]},{"name":"mf_uses_sleep_aids","label":"Do you use any sleep aids?","type":"radio","options":["Yes","No"],"required":true}]},{"title":"Medicare / IHI Details","subtitle":"Your details are securely stored and only accessible to our clinical team. This information is required under Australian telehealth regulations for prescribing medication.","fields":[{"name":"medicare_or_ihi","label":"Which healthcare identifier do you have?","type":"radio","options":[{"label":"Medicare","value":"medicare"},{"label":"IHI","value":"ihi"}],"required":true},{"name":"medicarenumber","label":"Medicare Card Number","type":"text","required":true,"showIf":{"field":"medicare_or_ihi","value":"medicare"}},{"name":"medicarereference","label":"IRN (Reference Number)","type":"text","required":true,"showIf":{"field":"medicare_or_ihi","value":"medicare"}},{"name":"medicareexpiry","label":"Expiry Date","type":"date","required":true,"showIf":{"field":"medicare_or_ihi","value":"medicare"}},{"name":"ihi_number","label":"IHI Number","type":"text","required":true,"showIf":{"field":"medicare_or_ihi","value":"ihi"}}]},{"title":"Identity & Consent","subtitle":"Last step — verify your identity and confirm consent.","fields":[{"name":"licence_photo_url","label":"Upload a photo of your photo ID (driver's licence or passport)","type":"file","required":true},{"name":"signed_name","label":"Type your full name as your signature","type":"text","required":true},{"name":"agreed_to_terms","label":"Consent","type":"checkbox","options":[{"label":"I confirm the information provided is accurate, and I consent to a telehealth consultation with a Modern Female doctor.","value":"true"}]}]}]

Recovery Assessment

A few quick questions so our doctors can tailor your plan.

Step 1 of

Thanks! Your assessment is in. Our doctors will review it and, once approved, your treatment will appear on your Treatments page.

If you don’t see your treatment on the Treatments page, try refreshing after a few moments.

Complete this step to continue.

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(select all that apply)","type":"checkbox","options":["Strength / Resistance","Cardio","Flexibility / Mobility","Mixed / Functional"]},{"name":"med_work_activity","label":"How active are you at work?","type":"radio","options":[{"label":"Sedentary","value":"sedentary"},{"label":"Lightly active","value":"lightly_active"},{"label":"Moderately active","value":"moderately_active"},{"label":"Highly physical","value":"highly_physical"}],"required":true}]},{"title":"Sleep & Recovery","subtitle":"How you're sleeping.","fields":[{"name":"med_sleep_hours","label":"How many hours do you sleep per night?","type":"radio","options":[{"label":"<5","value":"under_5"},{"label":"5–6","value":"5_6"},{"label":"6–7","value":"6_7"},{"label":"7–8","value":"7_8"},{"label":"8+","value":"8_plus"}],"required":true},{"name":"med_sleep_difficulties","label":"Do you have any difficulties with sleep? (select all that apply)","type":"checkbox","options":[{"label":"Falling asleep","value":"falling_asleep"},{"label":"Staying asleep","value":"staying_asleep"},{"label":"Early waking","value":"early_waking"},{"label":"Sleep feels unrefreshing","value":"unrefreshed"},{"label":"None","value":"none"}]},{"name":"mf_uses_sleep_aids","label":"Do you use any sleep aids?","type":"radio","options":["Yes","No"],"required":true}]},{"title":"Medicare / IHI Details","subtitle":"Your details are securely stored and only accessible to our clinical team. 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Anti-Ageing Assessment

A few quick questions so our doctors can tailor your plan.

Step 1 of

Thanks! Your assessment is in. Our doctors will review it and, once approved, your treatment will appear on your Treatments page.

If you don’t see your treatment on the Treatments page, try refreshing after a few moments.

Complete this step to continue.

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(select all that apply)","type":"checkbox","options":["Enhanced energy","Visible body composition changes","Better sleep","Faster recovery from training","Improved mental clarity","Reduced pain / inflammation"]}]},{"title":"Lifestyle","subtitle":"A few quick lifestyle questions.","fields":[{"name":"med_smoking","label":"Do you smoke or vape?","type":"radio","options":[{"label":"No","value":"no"},{"label":"Yes","value":"yes"},{"label":"Former smoker/vaper","value":"former"}],"required":true},{"name":"med_alcohol","label":"Do you consume alcohol?","type":"radio","options":[{"label":"No","value":"no"},{"label":"Yes","value":"yes"}],"required":true},{"name":"med_alcohol_frequency","label":"How many standard drinks per week?","type":"radio","options":[{"label":"1–3","value":"1_3"},{"label":"4–7","value":"4_7"},{"label":"8–14","value":"8_14"},{"label":"15+","value":"15_plus"}],"showIf":{"field":"med_alcohol","value":"yes"}},{"name":"mf_recreational_drugs","label":"Do you use any recreational drugs?","type":"radio","options":["Yes","No"],"required":true}]},{"title":"Activity & Exercise","subtitle":"How you move day to day.","fields":[{"name":"med_exercise_frequency","label":"How often do you exercise?","type":"radio","options":[{"label":"None","value":"none"},{"label":"1–2 sessions/week","value":"1_2"},{"label":"3–4 sessions/week","value":"3_4"},{"label":"5+ sessions/week","value":"5_plus"}],"required":true},{"name":"mf_exercise_types","label":"What types of exercise do you do? 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(select all that apply)","type":"checkbox","options":[{"label":"Falling asleep","value":"falling_asleep"},{"label":"Staying asleep","value":"staying_asleep"},{"label":"Early waking","value":"early_waking"},{"label":"Sleep feels unrefreshing","value":"unrefreshed"},{"label":"None","value":"none"}]},{"name":"mf_uses_sleep_aids","label":"Do you use any sleep aids?","type":"radio","options":["Yes","No"],"required":true}]},{"title":"Medicare / IHI Details","subtitle":"Your details are securely stored and only accessible to our clinical team. This information is required under Australian telehealth regulations for prescribing medication.","fields":[{"name":"medicare_or_ihi","label":"Which healthcare identifier do you have?","type":"radio","options":[{"label":"Medicare","value":"medicare"},{"label":"IHI","value":"ihi"}],"required":true},{"name":"medicarenumber","label":"Medicare Card Number","type":"text","required":true,"showIf":{"field":"medicare_or_ihi","value":"medicare"}},{"name":"medicarereference","label":"IRN (Reference Number)","type":"text","required":true,"showIf":{"field":"medicare_or_ihi","value":"medicare"}},{"name":"medicareexpiry","label":"Expiry Date","type":"date","required":true,"showIf":{"field":"medicare_or_ihi","value":"medicare"}},{"name":"ihi_number","label":"IHI Number","type":"text","required":true,"showIf":{"field":"medicare_or_ihi","value":"ihi"}}]},{"title":"Identity & Consent","subtitle":"Last step — verify your identity and confirm consent.","fields":[{"name":"licence_photo_url","label":"Upload a photo of your photo ID (driver's licence or passport)","type":"file","required":true},{"name":"signed_name","label":"Type your full name as your signature","type":"text","required":true},{"name":"agreed_to_terms","label":"Consent","type":"checkbox","options":[{"label":"I confirm the information provided is accurate, and I consent to a telehealth consultation with a Modern Female doctor.","value":"true"}]}]}]