A licensed provider will review your information and decide whether a prescription is appropriate. Most reviews complete within hours.
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Quick start
Tell us how to reach you so we can save your progress and follow up if anything goes wrong.
By continuing, you allow us to email or text you about this telehealth visit — status updates, provider messages, and prescription confirmations. This is required to deliver care. We never sell your information.
🛡️Your information is encrypted and protected under HIPAA. It is shared only with your reviewing provider and your chosen pharmacy.
⚠This service is not for medical emergencies. If you are experiencing a life-threatening condition, chest pain, suicidal thoughts, severe bleeding, or any emergency, call 911 immediately or go to the nearest ER.
About you
Tell us how to reach you.
We will use this to send your intake confirmation and updates from your provider.
What do you need help with?
Choose a program.
Pick the one that fits best. A provider will follow up with more questions if needed.
Which GLP-1 program?
Quick safety check
A few quick questions before we route you to a provider.
⚠ Safety note — please read
You can still submit this intake — your provider will review what you flagged and reach out. If this is a life-threatening emergency, please call 911 first.
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Sending to your pharmacy
In-network
You scanned this pharmacy's PrescriberNow QR — your prescription will be sent here automatically.
Preferred pharmacy (optional)
Tell us where you'd like the Rx sent. Your local CVS, Walgreens, Publix — any pharmacy works. Leave blank to use a network compounding pharmacy.
Clinical information
Help your provider help you.
The more accurate this is, the better the visit. A licensed clinician reviews everything.
Chief complaint
History of present illness
Vitals — self-reported
Medical history
Family history (parents, siblings)
Lifestyle
In the last 24 hours — any of these?
Check anything that's new, severe, or worse than usual. These help us catch anything urgent before your visit.
Almost done
Review and sign.
Please confirm each item below. All four are required to submit.
Type your full legal name to sign
By typing your name and tapping Submit, you electronically sign and agree to all of the above.
Final step
Pay your visit fee.
A licensed provider will review your intake as soon as your payment goes through. Card processed securely via Authorize.Net — we never see or store your card number.
Fee waivedYour visit fee is covered.
Telehealth visit fee$59.99
Total today$59.99
🔒 Card information
🔒 PCI-compliant tokenization · HIPAA-secure · TLS in transit · We never see your full card number
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Intake submitted.
A licensed provider in your state will review your information shortly and reach out from your patient dashboard.
PN-PENDING
Save this confirmation ID. You can use it to check your status anytime.
