One 2 One Diet with Sarah Valentine
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Apply to join 1:1 Diet

Cambridge Weight Plan with Sarah Valentine

Before you get started…

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Calculate your BMI

BMI calculator

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in
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Medical Info

Please read the Stop, Action & Go sections in the application below.

If any medical conditions apply a monitoring letter must be sent to your GP, and then the Step is dependent on the condition.

If none apply then tick the box ‘None Apply’ and no letter will be sent.

$

Calculate your BMI

BMI calculator

ft
in
lbs
cm
kg
$

Medical Info

Please read the Stop, Action & Go sections in the application below.

If any medical conditions apply a monitoring letter must be sent to your GP, and then the Step is dependent on the condition.

If none apply then tick the box ‘None Apply’ and no letter will be sent.

Apply to join the 1:1 Diet with Sarah Valentine

Client Application Form

Contact information

Name
Name
First
Last
Address
Address
Town/City
Region
Post code

Personal details

Click on Date of Birth to open the Calendar
Gender *
Typical weekly activity/exercise

Why are you thinking of starting on the 1:1 Diet.

What's your why? This is not just about losing weight and feeling healthier, fitting smaller clothes - drill down and discover why, deep down, you want to lose some weight and share this me ...

Lifestyle and Medical

These answers help me to recommend the best plan for your journey
Use the BMI calculator above this form

Stop! If any of the following apply you must not use any Cambridge Weight Plan Step:

NOTE: The 1:1 Diet by Cambridge Weight Plan is NOT appropriate for those who are alcoholic, substance misusers, underweight, pregnant, breastfeeding, or who have given birth in the last 3 months, and those younger than 14 years.
STOP: Do any of these conditions apply to you?

Medical Information

Action! Some medical conditions require us to send a monitoring letter to your GP, and then the Step is dependant on the condition.
ACTION: Do any of these conditions apply to you?
Any Step is suitable for:
Step 1B and above is suitable for:
Step 3 and above is suitable for:
Step 4 and above is suitable for:

Medical info continued.

Medical information: Before sending the monitoring letter, we would ask you to complete a Medical Enquiry Form online (MEF) for advice on a suitable Step for:
MEF: Do any of these conditions apply to you?

Go! For the listed medical conditions.

No monitoring letter is required, but the Step is dependent on the condition.
Step 1B and above is suitable for:
Step 3 and above is suitable for:
Complete an MEF for advice on a suitable Step for:
GO: Do any of these conditions apply to you?
Do you honestly think you are ready to start a weight loss journey

I have read and agree to the terms of this website and CWP and its privacy policy..

I have read and agree to the website privacy policy
If you answered YES to any questions in Section 3 your Cambridge Weight Plan Consultant (CC) you will need to send your GP a letter explaining that they may wish to monitor your medical condition or medications while you are following your Cambridge Weight Plan Step. Please confirm the following and sign. 1. The information given is correct and I have been advised to consult my GP before starting any weight loss programme. 2. I understand the importance of following the selected step according to directions given by my Cambridge consultant and additional literature supplied by the Cambridge weight plan 3. If my health status medication changes while using any Cambridge weight plan step I agree to notify my Cambridge consultant. 4. I consent to CWP and my CC holding the data on this personal record form in conjunction with my use of the program and for my doctor's dietitians and nurses to provide any data to my CC and CWP and vice versa. 5. I am aware that it is my responsibility as a client to have regular medical reviews with my GP to assess any medication adjustments. 6. I have been supplied with a CWP steps booklet by my CC.