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Failure to do so could result in a rejection of your order.","questionnaireID":62,"id":264},{"section":"80","title":"Please provide how many calories you consume on a daily basis?","parent":"0","type":"select","comment":null,"option":"[\"Less than 2000 per day\",\"2000-2500 per day\",\"More than 2500 per day\"]","isrequired":"1","questionnaireID":62,"id":265},{"section":"80","title":"How many times per week do you consume take away food?","parent":"0","type":"select","comment":null,"option":"[\"Occasionally\",\"Once a week\",\"More than once per week\"]","isrequired":"1","questionnaireID":62,"id":266},{"section":"80","title":"Do you regularly consume snacks (for example, chocolate, crisps,biscuits) ?","parent":"0","type":"select","comment":null,"option":"[\"Occasionally\",\"Once a week\",\"More than once per week\"]","isrequired":"1","questionnaireID":62,"id":267},{"section":"80","title":"How much exercise do you undertake per week?","parent":"0","type":"select","comment":null,"option":"[\"Less than 1 hour\",\"1-2 hours\",\"More than 2 hours\"]","isrequired":"1","questionnaireID":62,"id":268},{"section":"80","title":"Is there anything else you would like to tell us?","parent":"0","type":"radio","comment":null,"option":"[\"Yes\",\"No\"]","isrequired":"1","questionnaireID":62,"id":269},{"section":"80","title":"Please provide more information.","parent":"269","type":"textarea","comment":null,"conditions":"[\"Yes\"]","isrequired":"1","questionnaireID":62,"id":270},{"section":"80","title":"If possible, please upload any additional documents\/information that may support your medicine request i.e. repeats prescriptions\/letter.","parent":"0","type":"image","comment":null,"isrequired":"1","questionnaireID":62,"id":271},{"section":"81","title":"Would you like us to inform your GP of this consultation and any treatments that are prescribed for you?","parent":"0","type":"radio","comment":null,"option":"[\"Yes\",\"No\"]","isrequired":"1","questionnaireID":62,"id":272},{"section":"81","title":"-","parent":"272","type":"info","comment":"We recommend that you inform your GP of this consultation and any medication we prescribe to allow them to provide you with the best and safest care.\u201d","conditions":"[\"No\"]","isrequired":"1","questionnaireID":62,"id":273},{"section":"81","title":"Do you confirm the following?\r\n\r\nYou will read the patient information leaflet supplied with the medication.\r\nYou are over 18 years old.\r\nThe treatment is solely for your use.\r\nYou have answered all the questions truthfully and accurately to allow our doctors to provide you with a safe service as inaccurate information can be hazardous to your health.\r\nYou agree to our terms and conditions, privacy policy and acceptable use policy.","parent":"0","type":"radio","comment":null,"option":"[\"Yes\",\"No\"]","isrequired":"1","questionnaireID":62,"id":275},{"section":"81","title":"-","parent":"275","shop_url":null,"type":"notes","comment":"You must confirm in order to continue.","conditions":["No"],"id":"276","questionnaireID":62},{"section":"81","title":"-","parent":"0","type":"info","comment":"If treatment is not suitable, you will be fully refunded and signposted to another point of care. 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