GLP-1 intake demo

Step 1 of 6

Let’s start with you.

Use fictional information only. This browser-only demonstration cannot create a medical record or schedule care.

First nameAge

StateSex assigned at birth

I understand this is a test-only demo and will not submit real health information.

Step 2 of 6

Where are you starting from?

A provider may use measurements alongside your health history to understand your starting point. This demo does not calculate BMI or determine eligibility.

Height (feet)Height (inches)Current weight (lb)

How would you describe your recent weight experience?I have been working toward weight management for a whileI have noticed a recent change in my weightI am exploring my options for the first time

Step 3 of 6

What would you like to explore?

A provider will discuss the options that may be appropriate for you. Your selections here do not guarantee a treatment or prescription.

What brings you to Ours?Support for a weight-management conversationLearning whether GLP-1 care could be part of my optionsContinuing a conversation about a current care plan

Have you used a GLP-1 medication before?Yes, I currently use oneYes, I have used one in the pastNo, I have not used one before

Step 4 of 6

Let’s understand your health context.

These are examples of topics a provider may discuss. They do not replace a clinical evaluation or determine an outcome in this demo.

Are you pregnant, breastfeeding, or planning to become pregnant?

YesNoNot sure

Do you have a personal or family history of medullary thyroid cancer or MEN 2?

YesNoNot sure

Have you had pancreatitis, gallbladder disease, or a serious stomach-emptying problem?

YesNoNot sure

Step 5 of 6

A few final details.

Your clinician needs a complete medication history in a live intake. This preview only shows the type of questions that may be asked.

Do you currently take prescription medication for diabetes, blood sugar, insulin, or weight management?YesNoNot sure

How would you like to explore the cost of care?I would like to explore insurance optionsI would like to learn about cash-pay optionsI’m not sure yet

Step 6 of 6

Review your pathway.

You’ll continue to a $0 dummy checkout. It does not collect a payment method, bill you, submit an intake, or create a prescription.

DEMO ONLY

In a live experience, eligibility, diagnosis, treatment, and prescriptions are decided solely by an independent licensed clinician.

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I understand that continuing is for the demo experience only.