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Medical Intake Form
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What’s your BMI?
your current any
Do you have any of the following conditions?
Type 2 Diabetes
High Cholesterol
Polycystic Ovary Syndrome
High Blood Pressure
Sleep Apnea
Joint Pain
None of the above
Have you taken GLP-1 medications before?
Yes
No
Are you looking to continue your current medication or switch?
Stay
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Not sure
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