Your height
Your current weight (lbs)
Certain meds are available for pickup/delivery within 1-2 days if prescribed.
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The Basics
This information helps your healthcare provider determine if you’re eligible for treatment.
Basic Information
Let us know if you hold a government-funded primary or secondary plan. This doesn’t include federal, state, or city employee plans.
This list doesn’t include all potential government plans. Please review your plan to see if it’s fully or partially funded by the federal government before proceeding.
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This will help us determine your eligibility, even if you choose not to use insurance.
At this time, the Body Program can’t help patients coordinate insurance coverage if they’re uninsured or have insurance through Kaiser.
Popular cash-pay options
Compounded semaglutide: Same active ingredient as Ozempic & Wegovy and ready to ship in 1-4 days. Flat price of $297/mo.
Compounded Tirzepatide: Typically not covered by insurance for weight management but available for cash pay. Flat price of $397/mo.
We want to make sure there’s a provider overseeing your overall care.
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Include allergies to prescription or over-the-counter medicines, herbs, vitamins, supplements, food, dyes, or anything else.
Our Clinicians use this information in determining a safe and effective treatment.
Examples include tirzepatide (Zepbound/Mounjaro), liraglutide (Saxenda/Victoza), semaglutide (Wegovy/Ozempic), and dulaglutide (Trulicity).
Select all that apply
Include prescription and over-the-counter medications, herbs, minerals, inhalers, injections, and medication implants or patches. Do not include any medications that DPC is prescribing.
Our Clinicians use this information in determining a safe and effective treatment.
Knowing your race and/or ethnic background helps us work toward improving equally accessible, high-quality care for everyone on our platform.
However, you are not required to provide this information, and it won’t impact your treatment if you don’t.
Include any additional details about the conditions you’ve already reported.
A DPC-affiliated provider will review your health information to make sure that GLP-1s are right for you.
We have options to deliver medication right to your door.
To ensure patient safety, we need to verify your phone number. By providing your phone number and continuing, you agree that DPC may send you text messages for phone number verification and other lawful purposes related to your DPC account and services. This includes order confirmations, shipment notifications, and messages from your provider. Message and data rates may apply. Message frequency varies. Reply HELP for assistance. Reply STOP to opt out.