★ Please complete and submit the form below.
This helps us assess the suitability and safety of ProLon for you.
We’ll respond within 48 hours, either approving you for ProLon or inviting you to be assessed by one of our telehealth practitioners during a 15 minute phone call. (We’ll tell you how to book your consultation.)
If necessary, our telehealth practitioner will refer you back to your GP or specialist if there is a particular need. This happens infrequently. We do whatever we can to ensure that consuming reduced calories for five days will be safe for you.
Security of your information
Your personal information will be transferred and stored securely in an encrypted format.
We keep your information private and will only share it with the member of our telehealth team with whom you have an appointment (if you need one).
See our privacy and security policy for more details.