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Step 1 of 21 — Goal
Step 2 of 21 — Motivation
Step 3 of 21 — Your Body
Step 4 of 21 — About You
Step 5 of 21 — Date of birth
Step 6 of 21 — Challenges
Step 7 of 21 — Health & Safety
Step 8 of 21 — Health & Safety
Step 9 of 21 — Health & Safety
Step 10 of 21 — Health & Safety
Step 11 of 21 — Weight-loss medication history
Step 12 of 21 — Comorbidities
Step 13 of 21 — Medications
Step 14 of 21 — Allergies
Step 15 of 21 — Prior bariatric surgery
Step 16 of 21 — Lifestyle factors
Step 17 of 21 — Blood pressure
Step 18 of 21 — Heart rate
Step 19 of 21 — Formulation preferences
Step 20 of 21 — Anything else for the doctor
Step 21 of 21 — Your Profile
Goal

How much weight are you looking to lose?

Motivation

What's your main reason for starting now?

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Your Body

Let's calculate your personalized plan

Your goal weight is optional
Select*
4 ft
5 ft
6 ft
7 ft
Select*
0 in
1 in
2 in
3 in
4 in
5 in
6 in
7 in
8 in
9 in
10 in
11 in
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About You

Are you male or female?

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Date of birth

What is your date of birth?

Required for medical eligibility
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Patients like you typically

Lose in 3 months

Based on your starting profile and a personalized GLP-1 protocol.

Month 1
-9 lbs
Month 2
-18 lbs
Month 3
-27 lbs
Challenges

What's been the hardest part about
losing weight?

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Health & Safety

Do any of the following apply to you?

Select all that apply
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Health & Safety

Do any of these apply to you?

Select all that apply
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Health & Safety

Do any of these health conditions or situations apply to you?

Please note that any of these will require clearance from your primary care or other physician before we can prescribe medication.
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Health & Safety

Do any of these health conditions or situations apply to you?

Select all that apply
Has your gallbladder been surgically removed?*
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Weight-loss medication history

Are you currently taking or have recently (within the last 1 month) taken medication(s) for weight loss?

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Please list the name, dose, frequency, and timeline of your weight loss medication(s).

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What was your starting weight in pounds (lbs)?

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Do you agree to only obtain weight loss medication through this platform moving forward?

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When was your last dose of medication?

This question is required before further medication can be prescribed
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Please upload a picture of your current GLP-1 medication pen or vial.

JPG, PNG, WEBP · 10 MB
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If your last dose of GLP-1 medication was greater than 4 weeks ago, please note that we restart the dose at level 1 (the lowest dose) of medication.

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Comorbidities

Do any of these health conditions apply to you?

Select all that apply. Most of these won't disqualify you — for most, GLP-1 can help you even more.
Do any of these apply to your heart condition?*
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Medications

Please list your current prescription and over the counter medications, including name, dose, and frequency.

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Allergies

Please list your medication allergies, including name and reaction.

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Prior bariatric surgery

Have you had prior bariatric (weight loss) surgery?

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Lifestyle factors

Which of the following lifestyle factors apply to you?

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Blood pressure

What is your current or average blood pressure range?

Approximate is fine — this helps your provider plan your care
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Heart rate

What is your current or average resting heart rate range?

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Formulation preferences

If you are eligible, we take your specific situation into account while determining your medication formulation. To help with this, please select all of the following formulation options that you are interested in.

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Anything else for the doctor

Is there any further information which you would like the doctor to know? Please do not include urgent or emergency medical information here, as this is not reviewed immediately.

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Good news

You’re a strong candidate for GLP-1 treatment

Our licensed providers will review your information and build your personalized plan.

Your Profile

Last step — let’s create your profile

Your information is encrypted and never shared
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Choose your medication

All options include clinician support & free shipping.
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Your payment and personal information are securely encrypted

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