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Find out if you're a candidate for Medical Weight Loss
Evaluate your eligibility to participate in a medical weight loss program
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Have you tried other weight loss methods, such as diet and exercise, without success?
*
Yes
No
What is your gender?
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Male
Female
What is your body mass index (BMI)?
*
Below 18.5
18.6 to 24.9
25 to 29.9
30 and above
Click here to know your BMI
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CALCULATOR
Are you willing to inject yourself with medication once a week to aid in weight loss?
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Yes
No
Are you committed to making lifestyle changes, such as eating a healthy diet and exercising regularly, in conjunction with taking semaglutide?
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Yes
No
How much weight are you trying to lose?
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What have you tried so far?
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Do you have a history of pancreatitis?
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Yes
No
Do you have a history of thyroid cancer?
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Yes
No
Do you have diabetes?
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Yes - Type 1
Yes - Type 2
Yes - pre-diabetic
No
Are you pregnant or planning to become pregnant in the near future?
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Yes
No
Have you recently given birth?
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Yes
No
Are you breastfeeding?
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Yes
No
Do you have any contraindications or diagnosed allergies?
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Yes
No
what are the contraindications or allergies?
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Are you currently taking medications to manage your weight, blood sugar levels, or other health conditions?
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Yes
No.
Are you comfortable providing recent blood work or participating in a comprehensive health assessment?
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Yes
No
How much do you budget for your wellness each year?
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Less than $1000
Less than $10,000
More than $10,000
Enter your zip code
*
We need to make sure your state allows telehealth.
Name
*
First
Last
Email
*
Phone
How did you hear about us?
*
Facebook
Instagram
Ad on Google
Google Search
Other
Please specify
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If you heard about us from another source, please specify.
Our clinic is located in Hallandale, Florida, are you nearby?
*
Yes
I can make it
No, but I'm OK with a virtual consultation
If you live far, we do offer virtual consultations
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