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What can we help you with?

Weight LossLose weight with a doctor-led plan Hormone OptimizationMore energy, drive and strength Longevity and PerformanceFeel strong, sharp and well as you age Advanced DiagnosticsSee your numbers with blood work and at-home tests Not sure where to startTalk to our team

How old are you?

18 to 29 30 to 39 40 to 49 50 to 59 60 or older

This program is for adults and over. No booking, no capture.

Were you born male or female?

Female Male

How much weight are you trying to lose?

10 to 20 lbs 21 to 30 lbs 31 to 50 lbs More than 50 lbs

How tall are you, and how much do you weigh?

Height (feet)

ft

Height (inches)

in

Weight

lbs

Next

Have you used a weight loss medicine?

Yes, I use one now Yes, in the past No, never

Which two things helped you the most?

Pick up to 2

Fewer cravings More energy Less stress eating A plan that fits my time Help sticking with it Not sure

Next

What is your main reason for losing weight?

Pick up to 2

More energy Feel better in my body Keep up with my family Feel more confident A health goal Something else

Next

How active are you in a normal week?

Not much yet 1 to 2 days 3 to 4 days Most days

How many hours do you sleep most nights?

Less than 6 6 to 7 7 to 8 More than 8

If a provider says medicine is right for you, what would you prefer?

A weekly shot A daily pill No preference I'd rather not take medicine

What would you like help with?

Pick up to 3

Energy Strength Sex drive Mood or focus Sleep Hot flashes or night sweats

Next

How long have you felt this way?

A few weeks A few months About a year More than a year

How much does it bother you day to day?

A little Some A lot

Have you ever had a hormone blood test?

Yes No Not sure

Do you take any hormone medicine?

Yes, now Yes, in the past No Not sure

Have you talked to a doctor about this before?

Yes, and I was told I'm fine Yes, and I'm still working on it No, not yet

How is your stress on most days?

Low Some High It changes a lot

How active are you in a normal week?

Not much yet 1 to 2 days 3 to 4 days Most days

How many hours do you sleep most nights?

Less than 6 6 to 7 7 to 8 More than 8

What would you like to do first?

Check my hormone levels Talk it through with a provider Start a plan if it fits Not sure yet

What does living well for longer mean to you?

Pick up to 2

Living longer Feeling good day to day More energy Less stress Staying sharp Staying strong and recovering faster

Next

How stressed do you feel on most days?

Rarely stressed Sometimes stressed Often stressed Almost always stressed

What do you already do for your health?

Pick all that apply

Exercise most weeks Eat healthy food Track my sleep or steps Take vitamins Nothing yet

Next

When did you last have a blood test?

In the last year 1 to 2 years ago More than 2 years ago Never Not sure

How many hours do you sleep most nights?

Less than 6 6 to 7 7 to 8 More than 8

How is your energy on most days?

Low Up and down Good Great

What would you like help with first?

Pick up to 2

A full blood test A food plan Better sleep More energy Healthy aging treatments Not sure yet

Next

How fast do you bounce back after a hard workout or a busy day?

Fast A bit slow Slow Very slow

How soon would you like to start?

Right away In the next month In a few months Just looking for now

Where should we send your results?

First name

Last name

Email

Phone (optional)

I agree to be contacted by Holistically Rx about my results and booking. Send me tips and updates from Holistically Rx. (Optional)

See my results

Building your chart…

Reviewing your answers

Your weight

0 lbs

0 lbs

Based on a clinical trial average. Your results will vary. i

Continue

Your result · Weight Loss

Your weight chart

Result page copy from the Body copy doc goes here.

Book your first visit

Pick a time that works for you.

Book now

Your result · Hormone Optimization

How you feel now and what care aims to support

A guide based on your answers What care aims to support

Weeks are a rough guide, not a promise.

This is a simple picture. It is not a test of your hormones or a promise. Every body is different.

Result page copy from the Body copy doc goes here.

Only a licensed provider can decide what is right for you.

Book your first visit

Pick a time that works for you.

Book now

Your result · Longevity and Performance

Your starting map

Result page copy from the Body copy doc goes here.

Book your first visit

Pick a time that works for you.

Book now

Holistically Rx provides administrative and technology services and does not practice medicine or guarantee a prescription. Medical care is provided by independently licensed physicians and providers, who prescribe only when clinically appropriate. Content on this site is for general educational purposes only and is not medical advice (consistent with FTC guidance); individual results are not guaranteed. Compounded medications are not FDA-approved; they are prepared by US-based licensed pharmacies. We maintain Business Associate Agreements (BAAs) with third parties that handle protected health information, consistent with HIPAA (45 CFR Parts 160 and 164). Not a substitute for emergency care — call 911 in an emergency.

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