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Cryotherapy services in the City Of London, Belgravia and St John's Wood

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Your Weight. Your Health. Your Journey.

Weight Loss Programme

Welcome to your online assessment with LondonCryo. We will ask a series of questions to understand your eligibility for our Weight Loss Programme. Patient safety is at the heart of LondonCryo; all questions are designed to provide us with a detailed patient background.

LondonCryo Weight Loss Assessment

Welcome Screen

Please have your photo, ID, and prescriptions ready.

Full body photo
Photo on scales
Photo of prescriptions (if any)

Previous Assessment Query

Yes, I have completed before No, this is my first time

Enter Email Address (If Previously Completed)

If you have previously completed an assessment with us, please enter your email to retrieve your records.

Agreement & Consent

I am 18 or older and live in the UK
I confirm all information is true and accurate
I understand some treatments may be off-label

I agree and consent I do not consent

Consent Required

You must agree to proceed.

Age Verification

Under 18 18 to 74 75 or over

Not Eligible Due to Age

Sorry, you are not eligible for our programme due to age.

Ethnicity Selection

Healthy BMI ranges differ by ethnicity.

Asian or Asian British Black (Caribbean, African) Mixed ethnicities White Other

Sex Assigned at Birth

Male Female

Pregnancy Status

Yes No

Not Eligible Due to Pregnancy/Breastfeeding

You are not eligible if pregnant, breastfeeding, or trying to conceive.

Current Weight Input (kg)

Weight: 70.0 kg

Current Height Input (cm)

Height: 170 cm

Target Weight Input (kg)

Target Weight: 70.0 kg

Diabetes Diagnosis

This affects the medication included in the plan.

I have diabetes and take medication for it I have diabetes and it's diet controlled No, but there is family history I have pre-diabetes I don't have diabetes

Detailed Diabetes Condition Check

Diabetic Ketoacidosis (DKA) Type 1 Diabetes Diabetic Retinopathy Type 2 Diabetes (oral medication) Type 2 Diabetes (insulin)

Medical Conditions Screening

These conditions can lead to serious complications when losing weight or taking weight loss medications.

Chronic malabsorption syndrome Cholestasis / Gallstones

When was your last episode?

Within the last year More than a year ago

Currently being treated for cancer

When was your last treatment?

Currently receiving treatment Cleared; last treatment 6+ months ago Not sure

Severe heart failure

Most recent ejection fraction (EF)?

50-70% 41-49% 40% or less Above 75% Not Sure

Thyroid cancer (self/family) End-stage kidney disease

Latest eGFR?

> 90 60-89 45-59 30-44 15-29 < 15 Not sure

History of pancreatitis History of eating disorder Thyroid surgery

Please describe your thyroid surgery & monitoring

None of the above

Additional Conditions Affecting Eligibility

These conditions may help you qualify at a lower BMI.

Diagnosed mental health condition (depression, anxiety) Joint pains or aches Osteoarthritis GORD/indigestion Heart/cardiovascular problem High blood pressure (or family history) Fatty liver disease Sleep apnoea Asthma or COPD Erectile dysfunction Low testosterone Menopausal symptoms PCOS None of these statements apply to me

Other Medical Conditions

Yes No

Previous Weight Loss Treatment History

Yes No

Current Weight Loss Medication Details

Mounjaro Wegovy / Ozempic Saxenda Other (please specify) Maintenance Plan (reduce dose or taper off)

Mounjaro Dose Strength

2.5mg 5.0mg 7.5mg 10.0mg 12.5mg 15.0mg

Last Dose Date

Wegovy Dose Strength

0.25mg 0.50mg 1.00mg 1.70mg 2.40mg

Last Dose Date

Saxenda Dose Strength

0.60mg 1.20mg 1.80mg 2.40mg 3.00mg

Last Dose Date

Please Specify Other Medication

Maintenance Plan

Stay on my current dose Reduce until I get to a lower dose that works for me Reduce my dose until I taper off the medication completely

Upload Previous Prescription

Ensure image includes your full name, prescription date, medication name & dose

Max file size: 3MB

Upload Full-Body Photo

Please upload a clear, full-body photo (face visible).

Current Medications and Allergies

I'm on Levothyroxine I'm on Warfarin Other/Multiple Medications I have allergies No medications

Allergy Details

Personal & Contact Details

First Name: Last Name: Date of Birth: Mobile Number: Confirm Mobile Number: Email: Confirm Email:

Not Eligible to Proceed

Sorry, based on the information provided, you do not qualify for our weight loss programme.

Thank You

Thank you for completing the assessment. LondonCryo will be in touch soon.

LondonCryo

20 Artillery Lane,

London, England, EC2M,

United Kingdom

0203 371 8900 info@londoncryo.com

Hours

Mon 08:30 - 19:00

Tue 08:30 - 19:00

Wed 08:30 - 19:00

Thu 08:30 - 19:00

Fri 08:30 - 19:00

Sat 09:00 - 17:00

Sun 09:00 - 17:00

Londoncryo - city of london

20 Artillery Lane
London, E1 7LS
city@londoncryo.com
0203 371 8900 Ext: 1

Opening Hours

MON - FRI 10.00 aM - 7:00 PM
SAT - sun CLOSED

LondonCryo - Belgravia

15C Eccleston Place
London, SW1W 9NF
belgravia@londoncryo.com
0203 371 8900 Ext: 2

Opening Hours

MON - FRI 10:00 aM - 7:00 PM

saturdays 10:00am - 5:00pm
sundays 10:00 AM - 5:00 PM

LondonCryo - st johns wood

82 St John’s Wood High Street
London, NW8 7SH
stjohnswood@londoncryo.com
0203 371 8900 Ext: 3

OPENING HOURS
MON - FRI 10:00 AM - 7:00 PM
SAT - SUN 10:00 AM - 5:00 PM

walk ins welcome

Book AN APPOINTMENT

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LondonCryo Limited, Bank House, 81 St Judes Road, Englefield Green, UK TW20 0DF

Your Weight. Your Health. Your Journey.

Weight Loss Programme

Welcome Screen

Previous Assessment Query

Enter Email Address (If Previously Completed)

Agreement & Consent

Consent Required

Age Verification

Not Eligible Due to Age

Ethnicity Selection

Sex Assigned at Birth

Pregnancy Status

Not Eligible Due to Pregnancy/Breastfeeding

Current Weight Input (kg)

Current Height Input (cm)

Target Weight Input (kg)

Diabetes Diagnosis

Detailed Diabetes Condition Check

Medical Conditions Screening

Additional Conditions Affecting Eligibility

Other Medical Conditions

Previous Weight Loss Treatment History

Current Weight Loss Medication Details

Mounjaro Dose Strength

Last Dose Date

Wegovy Dose Strength

Last Dose Date

Saxenda Dose Strength

Last Dose Date

Please Specify Other Medication

Maintenance Plan

Upload Previous Prescription

Upload Full-Body Photo

Current Medications and Allergies

Allergy Details

Personal & Contact Details

Not Eligible to Proceed

Thank You

Londoncryo - city of london

MON - FRI 10.00 aM - 7:00 PMSAT - sun CLOSED

LondonCryo - Belgravia

MON - FRI 10:00 aM - 7:00 PM

saturdays 10:00am - 5:00pmsundays 10:00 AM - 5:00 PM

LondonCryo - st johns wood

MON - FRI 10.00 aM - 7:00 PM
SAT - sun CLOSED

saturdays 10:00am - 5:00pm
sundays 10:00 AM - 5:00 PM