Request a face-to-face consultation with one of our doctors below. Simply complete our short form and our team will be in touch with you promptly to arrange a time for your initial consultation. Have you had previous weight loss surgery?* Yes No Because you've had weight loss surgery before, please contact your GP or previous surgeon to discuss whether you are suitable for further weight loss surgery, before requesting a consultation at Sea Change.What is your age (in years)?*Because of your age, please contact your GP to discuss whether you might be suitable for weight loss surgery before requesting a consultation at Sea Change.What is your height (in cm)?*What is your weight (in kgs)?*Your body mass index (BMI)At your current BMI, you are unlikely to be suitable for weight loss surgery. Please see your GP to discuss other options.You are most likely eligible for our Weight Loss Medication Program and/or an Intragastric Balloon (this is a non-surgical procedure). Please enter your details below and our staff will be in contact to book your initial consultation at Sea Change.You may be suitable for weight loss surgery. Please enter your details below and our staff will be in contact to book your initial consultation at Sea Change.You’re highly likely to be suitable for weight loss surgery. Please enter your details below and our staff will be in contact to book your initial consultation at Sea Change.Which of our specialist doctors would you like to see?* Next available Dr Gately Dr McLeod Your name* First Last Email address* This field is hidden when viewing the formDate DD slash MM slash YYYY Phone number*What's the best time for us to try contacting you?*We will do our best to try to contact you at your preferred time, but please understand if that's not possible.Select..Any time (ASAP)8:00-8:59 am9:00-9:59 am10:00-10:59 am11:00-11:59 am12:00-12:59 pm1:00-1:59 pm2:00-2:59 pm3:00-3:59 pm4:00-4:59 pmHow did the patient first hear about Sea Change?*Select..Referring doctorWord of mouth (e.g. from a friend)Google search / our websiteSocial mediaChat groupOtherUnknownThis field is hidden when viewing the formSource pageThis field is hidden when viewing the formAFL UTM GCLID URLThis field is hidden when viewing the formAFL UTM GCLID URL CleanThis field is hidden when viewing the formAFL UTM FBCLID URLThis field is hidden when viewing the formAFL UTM FBCLID URL Clean
