off at home
What are your weight loss goals? Select all that apply & click NEXT
Lose stubborn weight
Fit into smaller clothes
Tighten up loose skin
What areas are you wanting to improve? Select all that apply & click NEXT
Has previous surgical work been done on these areas? Select one
Do you have any of the following medical issues? Select all that apply & click NEXT
High Blood Pressure
Type 1 Diabetes
Type 2 Diabetes
No Medical Issues
Other Medical Issues
How many days per week are you physically active/exercising? Select one
On those days, how rigorous is your activity/exercise? Select one
Are you on any of the following diets? Select one
Any questions about this treatment? Select all that apply & click NEXT
What will my results look like?
How long will it take to see results?
What's the cost?
Is there financing available?
How many injections will I need?
What is your preferred payment method for this treatment? Select one
What day would you prefer for your consultation? Select one
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