Please fill the form completely.
First Name and Last Name
Your email
Phone Number
Age
Weight
Height
Do you have an additional disease?
Do you have diabetes? Do you use insulin? How many years have you been suffering from diabetes? Do you take medication?
Do you have a heart problem?
Do you have high blood pressure?
Do you have any lung problems?
Do you have any medication?
Have you ever had an operation before?
Did you lose weight in the dietitian observation?
