Semaglutide Eligibility Questionnaire

Please answer the 1 minute questionnaire to confirm your eligibility.
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Do any of the following apply to you?*

Please select the options below that apply to you. If none apply, select “None of the Below”.

    Do any of the following apply to you?*

    Please select the options below that apply to you. If none apply, select “None of the Below”.

      Do any of the following apply to you?*

      Please select the options below that apply to you. If none apply, select “None of the Below”.

        Do any of the following apply to you?*

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          Do any of the following apply to you?*

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            We're sorry, you are not eligible.

            Certain pre-existing conditions or medical situations do not permit patients to take semaglutide (GLP-1).