Health assessment
A few questions so our doctors can determine if you qualify.
Your height and weight
We'll show your BMI as you type.
Goal weight
An estimate is fine — your doctor will help refine it.
Sex assigned at birth
Used to tailor dosage and side-effect monitoring.
Date of birth
Must be 18 or older.
Do any of these apply to you?
If none, tap the option at the top.
Medical history
Tap anything that applies — your doctor needs the full picture.
Opiate use in the last 3 months?
Includes prescription opiate pain meds and opiate-based street drugs.
Prior weight-loss surgery?
e.g. gastric bypass, sleeve gastrectomy, band.
Prescription medication?
Anything currently prescribed — daily or as-needed.
Blood pressure range
If unsure, pick Normal — your doctor will verify.
Resting heart rate
Best measured in the morning, sitting still. Estimate is fine.
Weight-loss meds in the past 4 weeks?
Relevant for safety and dosing decisions.
Prior weight-management programs?
Diet plans, gym programs, supplements — anything structured.
What matters more to you?
We factor this into your recommendation.
Injection or tablet?
GLP-1 is available in both. Pick what suits your routine.
What would you like to achieve?
Select all that apply.
Anything else we should know?
Optional. Mention allergies, recent surgeries, or specific concerns.
Contact details
Your doctor uses these to reach you securely.
Review and submit
Quick summary of what you've shared. Please confirm each item below.
Your eligibility summary
Based on the answers you just shared.
What your answers suggest
Your answers suggest a clinician review may be appropriate. Only an NMC-registered doctor can confirm whether GLP-1 treatment is safe and suitable for you — a prescription is never guaranteed.
This is a screening and education tool, not a diagnosis or a prescription. Not for emergencies — call 112. Questions? Email help@zivolabs.org.