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What is your weight loss goal?

Losing 1-15 lbs
Losing 16-50 lbs
Losing 51+ lbs
No sure, I just need to lose weight

What is your current height & weight?

Feet
Inches
Weight (in lbs)
Your BMI: 0.0
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See how much weight you could lose

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The Basics

This information helps your healthcare provider determine if you're eligible for treatment.
Sex Assignment at Birth
Male
Female
Basic information
Birthdate
State
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

Do any of the following apply to you?

Currently pregnant, or actively trying to become pregnant
Breastfeeding or bottle-feeding with breastmilk
End-stage kidney disease (on or about to be on dialysis)
End-stage liver disease (cirrhosis)
Current or prior eating disorder (anorexia/bulimia/binge eating disorder/night eating disorder)
Cancer (active diagnosis, active treatment, or in remission or cancer-free for less than 5 continuous years; doesn't apply to non-melanoma skin cancer that was considered cured via simple excision alone)
Describe *
When was the cancer diagnosed?
required
What type of cancer was diagnosed?
Was there a surgery to remove the cancer?
How many years has it been since successful cancer removal?
Current suicidal thoughts and/or prior suicidal attempt
History of organ transplant on anti-rejection medication
Severe gastrointestinal condition (gastroparesis, blockage, inflammatory bowel disease)
None of above

Have you been diagnosed with, or do you suffer from, any of the following?

Select all that apply
Depression or bipolar disorder
Alcohol use disorder or substance use
History of Suicidal ideation or suicide attempts
An anxiety disorder or Panic disorder
Other psychiatric or psychological conditions
None of the above
*Due to the strength of our weight loss program, we cannot enable restrictive eating disorders. Are you currently diagnosed with or struggling with any of the following?

Do you have any allergies or any allergies to GLP 1 Medications?

Include any allergies any allergies to GLP-1 agonist medications tirzepatide (Mounjaro) liraglutide (Saxenda/Victoza) semaglutide (Wegovy/Ozempic) and dulaglutide (Trulicity) or to food dyes prescription or over the counter medications (e.g. antibiotic allergy medications) herbs, vitamins, supplements or anything else.
Yes
Describe Allergies *
No

Do any of these apply to you?

High cholesterol or triglycerides
Describe *
Sleep apnea
Describe *
Hypertension (high blood pressure)
Describe *
Gallbladder disease
Describe *
Alcohol/substance use disorder
Describe *
Seizures
Describe *
History of or current pancreatitis
Describe *
Personal or family history of thyroid cyst/nodule, thyroid cancer, medullary thyroid carcinoma, or multiple endocrine neoplasia syndrome type 2
Describe *
Kidney disease
Describe *
Elevated resting heart rate (tachycardia)
Describe *
Congestive heart failure
Describe *
None of above

Do you currently take any medications?

Including prescription medications, over-the-counter medication, or recreational drugs?
Yes
Describe *
I don't take any medications

Enter personal data

First Name
Last Name
Phone number

Congrats! You're qualified to proceed *

Choose your medication preference:
Compare plans Choose your workspace plan according to your organisational plan
1-Month
Duration
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Active ingredient Dosing Starting at Availability Weekly injection Free fast shipping Supplies 24/7 provider messaging FSA/HSA
1-Month
Duration
7-Month
4-Month
10-Month
1-Month
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*The answers you provided to the quiz indicate that no initial exclusionary criteria screen you out of eligibility for the medications above. A medical clinician will review your answers after checkout to determine if you qualify for a prescription. Note that while the medication you select above is your preference indicated to a clinician, the clinician will ultimately decide whether you qualify for such medication or if another option would be better given your health needs. If the doctor determines you do not qualify, we will refund you within 24 hours at no cost.

Shipping Address

Full name
Address

Billing Address

Billing is different from shipping information
Full name
State
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Not Found
Address

Upload DL picture or passport photo

PLEASE UPLOAD THE FRONT OF YOUR DRIVER'S LICENSE/ IDENTIFICATION, SO WHEN DOCTOR APPROVES YOUR ORDER, WE CAN SENT THE Rx TO OUR FULFILLMENT PHARMACY.

Thank you for uploading your ID!

Next, you will have a telemedicine appointment with your doctor. If you have any questions, feel free to contact our support team

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