Eligibility Check — Everglow Miami
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Step 1 of 12

Your goals

What are you hoping to improve by losing weight?

Choose the outcome that matters most to you.

Long-term health
Confidence & appearance
Brain fog & energy

About you

What is your biological sex?

This helps our clinicians assess your metabolism accurately.

Male
Female

Safety check

Are you currently pregnant, breastfeeding, or trying to become pregnant?

GLP-1 medications are not recommended during pregnancy or breastfeeding.

No
Yes

Measurements

Your height and weight

We use this to calculate your BMI and personalize your plan.

ft
in
lbs
lbs

Losing weight is easier than you think.

Here's your projected progress with a GLP-1 treatment plan.

LBS
LBSGoal Weight
Today 3 Months 6 Months
Pounds to lose
Of body weight
Lbs / week

Medical history

Have you ever taken a GLP-1 medication?

For example: Ozempic, Wegovy, Mounjaro or Zepbound.

Never taken
Have taken / currently taking

Almost done

What is your name?

Your information is kept private and protected under HIPAA.

Contact

Your email address

Used for care-related communication.

Contact

Your phone number

We may use this to contact you about your prescription if needed.

Eligibility

Lastly, your date of birth

Used to confirm eligibility. You must be at least 18 years old.

Final step

Confirm your consultation

Please confirm you are aware this will be an IN-PERSON consultation with one of our board-certified physicians, this is NOT a virtual appointment.

Address: 9400 NW 12th Ave, Bay 3, Miami, FL 33150

I will make it for an in-person appointment
I am unable to make an in-person appointment

You're all set.

A licensed clinician will review your profile and reach out shortly. Check your email for next steps.

Please answer to continue.