Thank You - Patientory Care

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Drop 15 to 20% of Your Body Weight effortlessly.

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What was your gender at birth?

Male Female

What is your date of birth?

What is your age?

What is your height (ft,in)?

How much do you weight (lbs)?

BMI, which stands for Body Mass Index. It is a simple calculation using a person’s height and weight to estimate body fat. BMI is used as a screening tool to identify weight categories that may lead to health problems.

The formula for calculating BMI in pounds is: BMI = (weight in pounds / (height in inches)^2) * 703

Do you have any of the following conditions (select all that apply)?

High Cholesterol or Triglycerides / Dyslipidemia Fatty Liver Disease High Blood Pressure (Hypertension) PCOS Metabolic Syndrome Cardiovascular Disease Pre Diabetes / Type 2 Diabetes / Hbac 1 above 5.7 Osteoarthritis Obstructive Sleep Apnea None of the above

Do you have any of the following symptoms (select all that apply)?

Medullary Thyroid Cancer (MTC) or family history of MTC Multiple Endocrine Neoplasia Syndrome Type 2 (MEN 2) Serious Allergic reaction to Semaglutide or Tirzepitide Active Cancer Active Drug or Alcohol Misuse Eating disorders Bipolar Disorder Schizophrenia Pancreatitis Pregnant or planning to become pregnant in the next 2 months None of the above

What is your weight loss goal?

Lose over 50 lbs for good Lose 21-50lbs for good Lose 1-20lbs for good Maintain my health weight None of the above

What weight-loss initiatives have you tried in the past?

Exercise Dieting Weight-loss Supplements Intermittent fasting Other GLP1s Others not listed None of the above

Which GLP-1 are you interested in?

Compounded Semaglutide Compounded Tirzepatide Mounjaro® Wegovy® Ozempic® Rybelsus®

We pride ourselves on affordable, permanent weight loss solutions

Our patients have over 95% success in achieving their weight loss goals.
Quick approval process—no insurance needed.

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Let us know where we can send your weight management program.

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