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Secure medical intake

Your health is in expert hands.

Our licensed medical team reviews your information and determines if treatment is right for you.

  • Licensed U.S. providers
  • Secure & 100% confidential
  • No insurance required
  • Simple, transparent pricing
Your Care TeamBoard-certified and experienced providers dedicated to your care.
6 providers
Dr. Andrew Morel, MD
Dr. Andrew Morel, MDLead Diabetes Care
Dr. Edmond Samadi, MD
Dr. Edmond Samadi, MDPrimary Care Support
Nigel James, PA-C, PA
Nigel James, PA-C, PAMetabolic Health
Dr. Fremlin Dekyi, MD
Dr. Fremlin Dekyi, MDFamily Medicine
Dr. Yasmen Atef Srour, MD
Dr. Yasmen Atef Srour, MDUrgent Visit Care
Agata Sitek, FNP-BC
Agata Sitek, FNP-BCFamily Nurse Practitioner
A licensed provider will review your information. Your information is protected and never shared.
Stage 1 of 6

About You

Welcome to Our Medical Intake Process

This form will help us understand your medical history and treatment goals for GLP-1/GLP-2 therapy.

Please have the following information ready:

  • Personal information (name, contact details)
  • Medical history and conditions
  • Current medications and allergies
  • Insurance information (if applicable)

The form will take approximately 10-15 minutes to complete.

You can navigate between pages using the Next and Previous buttons.

Personal Information

Address Information

Medical History

Please select all that apply:

Current Medications

Please select all that apply:

Allergies

Weight & Health Goals

Previous Weight Loss Experience

Please select all that apply:

Lifestyle Information

Please select the applicable option:

Women's Health (If Applicable)

Additional Information

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Select Your Product

Consent

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Care that fits your life.

100% onlineComplete your intake from home, on your schedule.
Personalized plansTreatment is tailored to your health and goals.
Delivered to youMedication and supplies shipped discreetly.
Ongoing supportWe’re here for you through every step.