It's great to hear you're interested. Let's see if you're eligible for our program!

Last Name *

First Name *

Email *

Phone *

Current Age (in years) *

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Screening Consent *

This screening is for eligibility purposes only and does not establish a physician-patient relationship or constitute personalized medical advice. By continuing, you accept these terms. Consult your own physician for medical advice.

Do you principally reside (live in and spend most of your time) in South Carolina?

Yes, I live within the state of South Carolina

No, I do not live in the state of South Carolina

Height - Feet *

Height - Inches *

Weight (in Pounds) *

Do any of the following apply to you?

Personal or family history of Multiple Endocrine Neoplasia Syndrome Type 2.
Personal or family (first-degree relative) history of Medullary thyroid cancer.
Bariatric surgery within the last 6 month.

Please select one *

Yes, one or more of the above conditions applies to me.

No, none of the above applies to me.

I'm not sure.

Are you currently Pregnant, Nursing or planning to become pregnant in the next 2 months?

Yes

Do any of the following apply to you?

I have had pancreatitis in the past.
I have been diagnosed by a medical professional as having an eating disorder (past or present).
I have a mental health condition that required hospitalization in the last 12 months.
I have been diagnosed with 1 or more of the following:
- Liver cirrhosis
- Currently receiving radiation or chemotherapy.
- Diabetes requiring insulin use.

Please select one *

Yes, one or more of the above conditions applies to me.

No, none of the above applies to me.

I'm not sure.

Are you currently prepared to invest at least $500 per month in concierge physician-directed metabolic care, understanding that if you are medically eligible and choose to use medication, this may be an additional investment of up to $500 per month?

Yes, I’m prepared to invest $1,000+ per month in my health if needed.

Yes, I can comfortably invest around $500–$1,000 per month.

I could stretch to around $300–$500 per month.

No, I’m not in a position to invest at this level right now.

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