Book Your Consultation

Complete your health intake form below, then select your preferred appointment time. Your information is strictly confidential.

Consultation Intake Form

Step 1 of 7
About You
Your Health
Your Lifestyle
Weight Journey
Declaration
Readiness
Schedule

1) About You

1.1) Name *

1.2) Address *

1.3) Phone Number *

1.4) Email Address *

1.5) Date of Birth *

1.5.1) Age

1.6) Gender *

1.7) Weight

ST

LBS

1.8) Height

FT

IN

1.9) BMI (auto-calculated)

1.10) Usual Blood Pressure Range

1 / 7

Why We Collect This

This intake form mirrors the clinical assessment used in our National Medical Weight Loss Programme (NMWLP). Completing it before your appointment allows Dr. Ankrah to arrive fully prepared, making every minute of your consultation count.

Consultation Types

In-Clinic Consultation

Accra, Dakar, Bissau or London

Telehealth Consultation

Anywhere in the world

Initial Consultation

60 minutes

Follow-Up Consultation

30 minutes

Your data is encrypted and handled in full compliance with GDPR. It is shared only with your Aya Health clinical team.

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Visit our contact page