What's your weight loss goal?

What are you hoping to improve by losing weight?

Have you taken a GLP-1 medication in the past 2 months?

Examples: Ozempic, Wegovy, Zepbound, or Mounjaro, Compounded semaglutide, Compounded Tirzepatide

Let's calculate your bmi

Important information about this product

Read the following for more information about this product and it's potential side effects..

The traditional use of weight loss medications is for individuals with a BMI of 30 and above or to those who are overweight who have associated health conditions. Using it for someone with a BMI range (27-29) without an accompanying health condition is termed "off-label." Using a medication "off-label" refers to the practice of prescribing a drug for a purpose, age group, dosage, or form of administration that is not included in the approved labeling by regulatory agencies like the U.S. Food and Drug Administration (FDA). While a medication undergoes rigorous testing for specific uses before receiving approval, healthcare providers may discover through clinical experience or research that it can be effective for treating other conditions. There may be benefits such as weight reduction for individuals within your range. If you agree to this off-label use, it's crucial to follow the prescribed regimen and report any concerns. Please discuss any questions with us.

What was your starting weight in pounds?

Please specify the weight in pounds (lbs). Example: 215 lbs..

Are you currently pregnant, breastfeeding, or planning pregnancy within the next 3 months?

Please review and agree to the following breastfeeding/

pregnancy precaution

Read the following for more information about this product and it's potential side effects..

The FDA says that these medications may pose a risk to the developing fetus (baby) if you get pregnant while taking it. “The pill” (oral contraception) is not enough because this medication can interfere with the effectiveness. For effective birth control our doctors recommend to use condoms, an IUD, or the implant. Official FDA recommendations: For the first month after first starting a weight loss medication, and for the first month after each dose escalation, continue using your oral contraception and talk with your doctor about any additional measures that may be recommended to prevent pregnancy. Alternatively, you can switch to a non-oral contraceptive method (such as an IUD or implant) before starting your medication. When you stop the medication, you must continue using a backup method (like condoms) for two months after stopping to allow the medication to fully leave your system before getting pregnant. Similarly, it is not known to be safe in breastfeeding. If you are breastfeeding, consult your doctor for safe weight loss options.

When were you first diagnosed as obese or overweight?

If you have not been diagnosed, then select "unsure"..

Are you currently managing your weight?

How active are you?

Are you following any dietary plans?

Do any of these apply to you?

These will not automatically disqualify you, please always be honest with your history.

Please tell us more about your medical condition(s) that you selected. 

Do any of these apply to you?

Have you had any abdominal, pelvic, or weight loss (bariatric/gastric bypass) surgery?

Do you take any of the following medications?

Do you have any drug or food allergies?

Please list all drugs and food that you are allergic to and the reaction that each allergy causes 

(e.g., rash, anaphylaxis, nausea).

Do you have any other medical condition(s) you want to tell your doctor?

Surgeries, prior conditions, etc.

Please list your medical condition(s), any prior surgeries, or other message to your doctor.

Please include the name, dose, and frequency of all non-GLP1 medications you are currently taking.

Or if not taking any medications, please type none

You're almost done! We have just a few more questions.

Click "Next" to create your weight loss profile and see if you're eligible for treatment.

We need your  permission to provide telehealth services. 

The following questions...

The next section measures how you are currently progressing with your weight-loss treatment.

All fields must be completed to provide your medical provider with a full treatment history.

Complete information is required to properly evaluate your eligibility for treatment.

Incomplete responses may result in a delay or denial of treatment.

Have you taken any of the following medications in the last 60 days?

Please provide the exact dose of the GLP-1 medication you most recently took?

EXAMPLE: Semaglutide 0.25mg, if none- type NA

Your provider requires this to approve your prescription. Please be exact — missing or inaccurate details may result in denial.

Please provide the exact dose of units for the GLP-1 medication you most recently took?

EXAMPLE: Semaglutide 20 units once per week, if none- type NA

Your provider requires this to approve your prescription. Please be exact — missing or inaccurate details may result in denial.

Do you know the last date you took your medication?

When do you believe you last took your medication?

Have you experienced any of the following side effects from your current medication?

(Select all that apply)

Are you currently taking the max dose of your medication?

Please be certain of your dose before you answer.

Are you losing 1 - 2 lbs. of weight per week?

Would you like your medical provider to consider a personalized dosage?

Personalized dosages can improve patient's treatment experience.

Do you want to continue on your current dosing plan or would you like to make a change?

What core ingredient would you like your provider to consider?

Important Confirmations Before You Continue