Returning patients
Follow-up / refill visit
Complete this questionnaire before each refill so a licensed clinician can review your progress, side effects, and dose needs. Pricing is the same as your standard follow-up visit.
How it works
- Complete Part A (all patients), then the module for each medication you are refilling, then Part C attestation.
- Weight management refills are typically due 5–7 days before each monthly GLP-1 refill (required before dose step-ups).
- Other treatments: typically 10 days before each 90-day refill.
- At 12 months, a full re-intake replaces this form (including ID and state verification).
Questions marked red flag may place your refill on hold until a clinician reviews your chart and contacts you within one business day. If you are in crisis, call or text 988.