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About You → Contact Info → Referral Code → Recommendation → Medical Intake
What are your primary goals?
Select all that apply.
What type of care are you looking for?
Where are you located?
This helps us confirm availability in your area.
Tell us a bit about yourself.
Gender
Where can we send your results?
Do you have a referral or promo code?
Both fields are optional.
Based on your answers, we recommend:
GLP-1 Weight Loss Program
Doctor evaluation
Lab testing if needed
Prescription evaluation
Ongoing support
Ready for your medical intake?
You'll be guided through a secure medical intake with our clinical partner. Takes about 10 minutes.
HIPAA-compliant & secure
Reviewed by a licensed provider
Prescription sent directly to you
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You're all set!
Your information has been submitted. A member of the Pepteeva Health team will reach out shortly to guide your next steps.
Check your inbox for a confirmation email.