Semaglutide Weight Loss Program
FORMS
New Patient Forms
If you are a new patient to the clinic, please submit the HIPAA-compliant NEW PATIENT form for either semaglutide or tirzepatide, depending on the medication you think you may want. If you don’t know yet which medication you prefer, go ahead and fill out the form for semaglutide. Please submit this form at least 24 hours prior to your appointment. Late forms may require us to reschedule your appointment.
Follow-Up Forms
For follow-up appointments, use the HIPAA-compliant forms below for either semaglutide or tirzepatide before each follow-up appointment. Please submit at least 12 hours before your appointment.
Set up your consultation appointment today to see how we can help restore your hormone balance.
