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You can obtain the Cambridge Diet throughout the UK and Southern Ireland from accredited Cambridge Counsellors. For information about your nearest UK/Eire Counsellor, please complete the form below and click on the SEND button.

This facility within our Cambridge Diet site is totally secure and your data will only be viewed in the strictest confidence by Cambridge Health Plan Limited.

Title:
Forename:
Surname:
Address:
Postcode:	(essential for a convenient match)
Home Phone Number:
Fax Number:
Email address:
	Please check your email address is correct
If you would prefer to see a counsellor in an alternative postcode, e.g. where you work,
please enter here.
Date of Birth:
Height:	Feet Inches Or Metres
Current Weight:	Kg Stone
Have you used Cambridge Diet before?:	Select An Option Yes No
Where did you find out about Cambridge Diet?:
List all the diets you have used before:
Your Counsellor will ask you other questions to recommend the most appropriate programme for you.
How would you like us to contact you?:	Please Select An Option Phone Email Fax
Whichever method of contact you prefer please make sure you have supplied the relevant number or address. Thank you for taking the time to complete the form. We will be in touch as soon as possible.
If you prefer not to send the form, you can contact us direct on Freephone: 0800 161412 (Within UK Only) Or 01536 403344/Fax: 01536 202396 Post: Cambridge Health & Weight Plan, Clare House, Hunters Road, Corby, Northants NN17 5JE © 2005 Cambridge Health & Weight Plan