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System Slim - New Zealand weight loss programme offers consultations and products

Joining Form


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Complete the form below to become an Online / DIY member of system:slim.
After completing the form, you will be redirected to our online shop to purchase your home support pack.
Please note that purchasing the home support pack is a required step for joining online. Once your purchase has been confirmed, you will be sent a password.
This password can be used along with your email address to login to our online client area, and access the great tools and information available there.

  • * Required fields
  • Personal Details


  • Please enter first name

  • Please enter last name

  • Please enter an address

  • Please enter city

  • Please enter phone number

  • Please enter email

    Invalid email entered
  • Male Female

    Please select a gender

  • Please enter select date of birth
  • (kg)
  • (cm)
  • (kg)

Medical History

  • Yes No
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  • Yes No
  • If you have ticked any of the conditions above please explain
    eg. Eczema caused by dairy is not controlled,
    poor sleep have trouble getting off to sleep:
  • Yes No
  • Yes No

Activity/Exercise

  • (Inactive)1 2 3 4 5 (Athlete)

Present Eating Habits

  • Breakfast
    What and how much do you eat?:
  • Mid Morning
    What and how much do you eat?:
  • Lunch
    What and how much do you eat?:
  • Mid Afternoon / Pre dinner nibbles
    What and how much do you eat?:
  • Dinner
    What and how much do you eat?:
  • Snacks / Dessert
    What and how much do you eat?:
  • Coffee / Soft drinks / Alcohol / Juice
    What and how much do you drink?:
  • Water
    How much water do you drink each day?:
  • Dining Out / Takeaways
    What type and how often?:
  • Do you have any particulars likes or
    dislikes around food?

  • Briefly detail what caused you to be overweight,
    including details of your previous weight loss
    programmes.
  • Why do you want to lose weight?
    Do you have a special event or date?
  • I believe that the information I have given is true to the best of my knowledge.
  • I'm happy to receive promotional newsletters from system:slim.
  • Yes, I would like to receive email reminders to re-order products
  • I have read and understood the health disclaimer *

    Please read and accept the Health Disclaimer

  • Errors have occurred, please check all required fields have been completed.

Health Disclaimer

If you choose to purchase system:slim products online, you will not have any contact with system:slim staff or trained system:slim Consultants. You therefore need to take full responsibility for your own health and weight loss if you chose to join the system:slim Program online.

For your own health and safety, you must not join system:slim online if you:

  • Have Insulin dependent diabetes
  • Have a BMI below 18 (you are underweight)
  • Have an eating disorder or a history of an eating disorder
  • Are pregnant or breast feeding
  • Are under 16 years of age

If any of these apply to you, you may however seek medical written approval (as outlined in Health Disclaimer - Joining at a system:slim Clinic. 

If you are taking any medication or have any concerns about your suitability to a weight management program, you must consult with your doctor or health care professional before joining the system:slim Weight Management Programme Online.