1 : Are you 18 years of age or older?

Yes

No

2 : What state are you physically located in today?

3 : Are you experiencing a medical or psychiatric emergency right now?

Yes

No

4 : What is your primary goal?

Loose Weight

Improve Metabolic Health

Maintain Weight Loss

Explore Medication option

5 : Which best describes you?

BMI

Weight concern known

Weight related conditions

Not sure

6 : Are you currently pregnant, breastfeeding, or actively trying to become pregnant?

Yes

No

Not sure

7 : Are you looking only for a prescription without a medical evaluation or follow-up?

Yes

No

8 : Are you willing to complete labs or provide recent results if your clinician determines they are needed?

Yes

No