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Program Overview

Program Phases

Measuring Waist

KicStart™ VLCD

Portion Control

Privacy

Heart Disease

Healthy Weight For Life Program Application


IMPORTANT: Some internet email servers have been known to block automated email deliveries. If you do not receive an email confirming your application within the next 45 minutes, please send an email to hwflheart@hwfl.com.au with your name and contact details or call the Healthy Weight for Life team on 1800 226 180 and we will send it to you personally.

In order to be able to participate in the Healthy Weight For Life program, you must read, understand and agree to the following statements, and indicate so by checking each statement.

You will then be asked to enter your personal details, and fill out the baseline health survey.

Once you have completed the online application, a confirmation e-mail will be sent to your nominated e-mail address. Attached to this e-mail will be the “Application and GP Approval Form”, you will need to print out this form, fill in your details and take it to your GP. Once your doctor gives their approval for you to participate then you need to fax the form back to your health fund who will then activate your account.

YOUR SAFETY

Yes, I have viewed and understood the following presentations on the Healthy Weight For Life homepage and now wish to enrol in the Healthy Weight For Life program.

I understand that KicStart™ VLCD sachets contain milk and soy products. The soup sachets contain gluten, but the shakes are gluten free (undetectable at 5ppm).

(Members who are allergic or intolerant to any of the ingredients in KicStart™ should take this into consideration before deciding to participate in this program. More information on the nutritional content of KicStart™ can be accessed from the KicStart™ VLCD page.)

I understand that KicStart™ may be unsuitable for use by pregnant, nursing or lactating women, or by infants, children, adolescents or the elderly. I am not pregnant or breastfeeding, nor intending to become pregnant during the next 18 weeks.

I understand people with gout, gall bladder, heart, kidney, or liver problems, or are aged over 65 should be carefully assessed by their GP or medical specialist to determine if the Healthy Weight For Life program is suitable for them. If enrolled, regular supervision by a GP is then required.

I have read and understood the "IMPORTANT" statement on the top of the page and I understand that if I am being treated for diabetes, high blood pressure or cholesterol, or if I am on lithium therapy, it is particularly important that my doctor maintains close supervision and monitors my medication carefully whilst I am on a weight loss program (including the Healthy Weight For Life program). I will not stop or reduce my medications without my doctor's prior approval.

YOUR ELIGIBILITY

I have a current private health insurance hospital policy with a participating health fund that I have held for at least 12 months.

I am 18 years or older and I have medically diagnosed (or am at risk of developing) heart disease and I have a body mass index (BMI) of 28 or greater.

I understand that it is a requirement of participation that I provide regular updates on my progress.

YOUR PRIVACY

I have read and agree with my health fund's privacy statement.

In order to facilitate evaluation of the program I consent to my identifiable body mass index (BMI) to be shared with my health fund. I also consent to my additional ANONYMOUS (de-identified) health information to be used by Prima Health Solutions, participating health funds and medical researchers to assess and report on the effectiveness of the program. No public document or report will identify any individual participant.

I understand that Prima Health Solutions Pty Ltd will be co-ordinating the Healthy Weight For Life program and during the program will need to collect information on my:

  • age
  • height
  • weight
  • waist circumference
  • blood pressure
  • cholesterol levels (total, HDL and LDL)
  • triglycerides
  • HbA1c
  • health status

I understand that Prima Health Solutions Pty Ltd will ONLY use my information for the purposes of running and assessing the Healthy Weight For Life program. I understand that the clinical staff from my health fund may request to sight the information provided on my GP Approval form in order to confirm my clinical eligibility before authorising funding approval for my program.

Additional Help, Information, Support

For additional help, information or support please don't hesitate to contact the Healthy Weight For Life team at any time on

Phone: 1800 226 180 (free call)
Email:  hwflheart@hwfl.com.au
Web:   http://hearthealth.hwfl.com.au

Complaints or Concerns

If you have a complaint or concern about any aspect of the Healthy Weight for Life program please don't hesitate to contact Luke Lawler, Prima Health Solutions Pty Ltd Scientific Director directly, on

Phone: 1800 226 180 (free call)
Email: luke@primahealth.com.au

 

About Prima Health Solutions

PRIMA is a quality certified health care organisation (AS/NZS ISO 9001:2015) that is dedicated to the research, development and remote delivery of specialised obesity related chronic disease management and prevention products and programs.

The PRIMA products and services include KicStart™ VLCD, the Osteoarthritis Healthy Weight for Life program, the Type 2 Diabetes and Heart Healthy Weight for Life™ programs.