№ lp_1_2_23871
File format: docx
Character count: 4627
File size: 4319 KB
Structured clinical referral form defining eligibility, exclusion criteria, required patient and clinical information, and submission requirements for access to an NHS weight management programme.
Document type:
Referral form
Eligibility criteria version:
QKK_20250821_v2.0
Healthcare system:
NHS
Country:
United Kingdom
Issuing body:
NHS
Intended use:
Clinical referral
Target population:
Adult patients with obesity
Age eligibility:
18 years and over
Clinical focus:
Obesity and related comorbidities
BMI thresholds:
≥40 kg/m2 or ≥35 kg/m2 with qualifying criteria
Ethnic adjustment:
Reduced BMI threshold for specified ethnic groups
Exclusion criteria included:
Yes
Referrer requirement:
Named GP only
Required clinical measurements:
Weight, height, BMI, HbA1c, blood pressure, renal function, lipid profile, thyroid function
Associated therapy:
GLP-1 therapy
Submission method:
Secure NHS mail or e-RS
Contact email:
[email protected]
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.
The file will be delivered to the email address provided at checkout within 12 hours.
Don’t have cryptocurrency yet?
You can still complete your purchase in a few minutes:- Buy Crypto in a trusted app (Coinbase, Kraken, Cash App or any similar service).
- In the app, tap Send.
- Select network, paste our wallet address.
- Send the exact amount shown above.
The final amount may vary slightly depending on the payment method.
The file will be sent to the email address provided at checkout within 24 hours.
The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2016
Region / City:
Canberra
Theme:
Neonatology, Premature Infant Care
Document Type:
Guideline
Institution:
Canberra Health Services
Author:
Department of Neonatology
Target Audience:
Clinicians (Medical Officers, Registered Nurses, Registered Midwives, Students)
Effective Period:
Ongoing
Approval Date:
Not specified
Revision Date:
Not specified
Year:
2025
Region / city:
Not specified
Topic:
Weight management, eligibility criteria
Document type:
Referral form
Organization / institution:
NHS
Author:
Not specified
Target audience:
Healthcare professionals (GPs, clinicians)
Period of validity:
Not specified
Approval date:
Not specified
Date of changes:
Not specified
Year:
2016
Region / city:
N/A
Topic:
Weight and balance of aircraft for LSA certification
Document Type:
Guideline
Organization / institution:
N/A
Author:
N/A
Target audience:
LSA certification applicants
Period of validity:
N/A
Approval date:
N/A
Revision date:
N/A
Year:
2022
Region / city:
Rome
Theme:
Persistent Organic Pollutants
Document type:
Technical report
Organization / institution:
United Nations Environment Programme (UNEP)
Author:
Secretariat of the Stockholm Convention
Target audience:
Stakeholders in environmental protection and chemical safety
Period of validity:
N/A
Approval date:
20 August 2022
Date of changes:
N/A
Year:
Semester:
Note:
Region / City
Topic:
Physical Education, Fitness
Document Type:
Self-Reflection, Progress Report
Author:
Eva Stryukova
Target Audience:
Students, Educators
Period of Effectiveness:
End of Semester
Contextual Description:
A self-reflection document by a student outlining progress and achievements in a weight training course, including personal growth in fitness, exercise techniques, and health management.
Document type:
Referral form
Programme level:
Tier 3 weight management
Eligibility criteria version:
QOQ_20250821_v3.0
Health system:
NHS
Referring authority:
Integrated Care Board
Referrer type:
General Practitioner
Patient age requirement:
18 years and over
BMI thresholds:
≥50 kg/m2; ≥40 kg/m2 with prior conservative management; ≥35 kg/m2 with comorbidities and prior conservative management
Adjusted BMI criteria:
Reduced by 2.5 kg/m2 for specified ethnic groups
Included comorbidities:
Hypertension; hyperinsulinaemia; dyslipidaemia; type 2 diabetes; psychosocial dysfunction; asthma exacerbation
Exclusion criteria:
Pregnancy; breastfeeding; uncontrolled cardiovascular disease; active eating disorders; active cancer; unstable mental illness; substance misuse; endocrine instability; prior bariatric surgery; previous Tier 3 programme participation
Required assessments:
Weight; height; BMI; HbA1c; blood pressure; renal function; lipid profile; thyroid function
Submission method:
Secure NHS mail or e-RS
Referral destination:
[email protected]
Year:
2023
Region / city:
United States
Subject:
Weight Management
Document Type:
Medical form
Organization / institution:
Microsoft
Author:
Not specified
Target Audience:
Microsoft employees and their covered dependents
Effective Period:
Not specified
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
2025
Region / City:
Humber and North Yorkshire
Topic:
Weight Loss Medications
Document Type:
FAQ
Institution:
Humber and North Yorkshire Integrated Care System (HNY ICB)
Target Audience:
Clinicians, Healthcare Providers
Period of Effect:
2025
Approval Date:
June 2025
Amendment Date:
TBD
Year:
2026
Region / City:
Australia
Topic:
Body mass management in athletes
Document Type:
Guideline
Organization:
Rowing Australia
Author:
Rowing Australia
Target Audience:
Athletes, coaches, performance support staff
Period of Action:
Ongoing
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
Not specified
Region / City:
Not specified
Subject:
Weight management, Type 2 diabetes, Clinical referrals
Document Type:
Referral form
Organization / Institution:
NHS
Author:
Not specified
Target Audience:
Healthcare professionals, General practitioners
Period of validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2024
Region / City:
Massachusetts
Topic:
Healthcare / Drug Coverage
Document Type:
Newsletter
Organization / Institution:
MassHealth
Author:
MassHealth Drug Utilization Review Program and the MassHealth Pharmacy Program
Target Audience:
Healthcare providers, MassHealth members
Period of Action:
From October 2024 to January 2025
Approval Date:
October 2024
Date of Changes:
October 2024
Contextual Description:
A newsletter detailing upcoming changes in MassHealth coverage for anti-obesity medications, including the introduction of Zepbound® (tirzepatide) as a preferred drug and updates to prior authorization requirements.
Note:
Year
Topic:
Physics, Mechanics
Document type:
Educational material
Target audience:
Students
Year:
Not specified
Region / city:
Not specified
Topic:
Forensic Science
Document Type:
Examination Subject Outline
Institution:
Not specified
Author:
Not specified
Target Audience:
Criminology students and professionals
Effective Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Note:
Year
Theme:
Social and Economic Data Analysis
Document Type:
Instructional Manual
Organization / Institution:
U.S. Census Bureau
Target Audience:
Data Analysts, Researchers
Year:
2025
Region / city:
National
Topic:
Weight management, obesity, diabetes, hypertension
Document type:
Guide
Organization:
NHS Digital
Author:
NHS England
Target audience:
Healthcare professionals, General Practitioners
Action period:
12 weeks
Approval date:
April 2025
Modification date:
April 2025
Contextual description:
A guide for general practices on referring patients to the NHS Digital Weight Management Programme for weight management support in individuals with obesity and related health conditions.
Year:
2019
Region / City:
United States
Topic:
Supplemental Security Income (SSI) Eligibility
Document Type:
Government Report
Agency / Organization:
Social Security Administration (SSA)
Author:
Social Security Administration
Target Audience:
SSI recipients or their representative payees
Period of Validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2011
Region / city:
United States
Document type:
Government report
Organization / institution:
Department of Veterans Affairs
Author:
Department of Veterans Affairs
Target audience:
Veterans, service personnel, and their dependents/beneficiaries
Period of validity:
Annual
Approval date:
May 11, 2011
Date of amendments:
None
Number of respondents:
219,000 per year
Frequency of response:
Annually
Total estimated cost to respondents:
$1,696,125
Total estimated cost to the government:
$3,555,672
Note:
Year
Topic:
Physiotherapy, Health Services
Document Type:
Procedure
Organization / Institution:
North Canberra Hospital, Clare Holland House
Year:
Not specified
Region / City:
Not specified
Subject:
Youth Employment, Eligibility Criteria, Documentation
Document Type:
Guidelines
Organization / Institution:
Not specified
Author:
Not specified
Target Audience:
Youth (14-24 years old)
Effective Period:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Year:
2022
Region / City:
Arizona
Subject:
Mental health, school wellness
Document Type:
Application Instructions
Organization:
Arizona Department of Education
Author:
Arizona Department of Education
Target Audience:
Local Educational Agencies (LEAs), school personnel, community partners
Period of validity:
09/30/2021 - 09/29/2026
Approval Date:
September 30, 2021
Amendment Date:
N/A