Revitalize Trim Spa — Eligibility Quiz
Your Goals

What are you hoping to improve by losing weight? *

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Months
Diet Without medicationWith GLP-1

On average, patients drop 12.3% body weight and 6.2 inches off their waist measurement after 6 months.

What is your biological Sex? *

Are you currently pregnant, breastfeeding, or trying to become pregnant? *

How tall are you?

Enter your details to see your BMI.
0BMI
Enter your height & weight

What is your goal weight? *

Awesome, this is easier than you think!

Let's analyze your metabolism and discover if GLP-1s are the right solution for you.
Today3 Months6 Months
--lbs
--lbsGoal
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Pounds to Lose
--%
Body Weight
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Lbs / Week

Have you ever been diagnosed with any of the following? *

Have you had any surgeries or medical procedures?

More Details about Surgeries and Medical Procedures

Are you currently taking or have you ever taken a GLP-1 medication?

More Details on Current GLP Meds

We're almost done! What is your name?

Your information is kept private and protected under HIPAA.

✉️ Your Email Address

Used for care related communication.

📞 Your Phone Number

We may use this to contact you about your prescription if needed.

Lastly, Your Date of Birth

Used to confirm eligibility. You must be at least 18 years old.

What is your preferred treatment?

Based on your answers, our clinicians will review your profile.

Checking your eligibility…

Hang tight while we review your answers.