MediFlex Weight Loss Program ⎸ Registration & Purchase

MediFlex Weight Loss Program

Please use the form below to register and place an order. This program is medically supervised and uses prescription medication to help manage a real problem that affects many individuals. Mediflex involves a bloodwork screening and health assessment that is then reviewed by a board-certified clinician.

You will be required to visit a lab center near you to complete bloodwork before having a telehealth consultation with a provider. Patients who are eligible are prescribed semaglutide (or GLP-1) injections that are self-administered at home.

New! There are also additional products available at the end of the form. These products are only available with a prescription, so please complete the form below to order.
New MediFlex PatientReturning MediFlex Patient / I'd like to refill my order.
Personal Details

Complete the fields below with your contact information. This allows us to create your profile.
Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Address*

Street Address

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CityState / Province

Postal / Zip Code
Date of Birth*

MonthDayYear
Date
What's your Instagram name? *
(@example) - If you have one, enter your Instagram handle below, this helps us stay in touch to keep track of your progress.
Initial Health Assessment

Please answer the questions below to the best of your ability.
YesNo
YesNo
YesNo
What is your height?*
Please enter your weight above in feet and/or inches.
What is your current body weight? *
Please enter your weight above in pounds.
What is your target body weight? *
Please enter your weight above in pounds.
What is the most you have weighed and what year was this?*
Please enter your weight above in pounds.
What is the least you have weighed and what year was this?*
Please enter your weight above in pounds.
What weight loss methods have been successful for you in the past? *
Low CalorieFried or High Fat FoodsVegetarianVeganLow CarbHigh Carb
Do you have any of the following health conditions?*

DiabetesGlaucomaOveractive ThyroidSevere Heart ProblemsUncontrolled High Blood PressureAdvanced Coronary Artery DiseaseHistory of Drug AbusePersonal or Family History of Thyroid CancerHistory of PancreatitisHistory of GastroparesisKidney Problems or Chronic Kidney DiseaseHistory of Hypoglycemia or Low Blood SugarHistory of HIVI do not have, and have not had, any of the diseases or problems listed above.Other
If you have any health conditions that are not listed above that you think we should know about, please enter them in the field below.
YesNo
YesNo
If so, please list them below.
Please enter the names of any drug allergies in the field above.
YesNo
Please list all or any of your medical conditions. *
Please list your current medications. *
I certify that all the above information is accurate to my knowledge. By signing below, I am giving my consent to MediFlex for evaluation and/or treatment. Once I have been examined, I understand that I will be informed of any medical or weight loss recommendations and/or treatments and given the option to accept or decline.*

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I acknowledge and accept full responsibility for administering the product only as prescribed by MediFlex provider. I will watch the video to learn how to self-inject. I am aware the instructional video is available to watch. I agree I will use the syringes and vitamins as directed.*

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I UNDERSTAND THIS IS A NON-REFUNDABLE PRODUCT AND CANNOT BE RETURNED. I AGREE TO THE REFUND POLICY AVAILABLE AT I authorize MediFlex to charge my credit card for agreed upon purchases. I understand that my information will be saved to file for future transactions on my account.*

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I understand that I should not be pregnant or become pregnant after submitting my order purchase. In the event of pregnancy reported after the actual purchase, I agree to forfeit any payments made.*

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Order Details

Complete your payment with your payment information. You will be contacted with next steps to complete your required blood work and screening, before your consultation with a physician.
Shipping Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Lipo In A Bottle Cream

Lipo In A Bottle Promo Bundle (2 Areas + 1 Free) - This bundle allows you to target 2 areas of your choice and receive a 3rd area treatment for free. Ideal for those looking to see results across multiple stubborn areas without surgery. Shipping not included. Price remains the same for pickup from Goals locations. - $999.00Lipo In A Bottle Cream (Face) - Lipo In A Bottle Cream designed specifically for the face to help reduce the appearance of a double chin and contour the jawline. Each bottle contains 30ml of formula. Shipping not included. Price remains the same for pickup from Goals locations. - $499.00Lipo In A Bottle Cream (Arms) - Lipo In A Bottle Cream designed to tone and tighten the arms, helping to reduce stubborn arm fat. Each bottle contains 30ml of formula. Shipping not included. Price remains the same for pickup from Goals locations. - $499.00Lipo In A Bottle Cream (Stomach) - Lipo In A Bottle Cream designed to help flatten and firm the stomach area, targeting belly fat for a smoother contour. Each bottle contains 30ml of formula. Shipping not included. Price remains the same for pickup from Goals locations. - $499.00Lipo In A Bottle Cream (FUPA) - Lipo In A Bottle Cream targeted for the lower belly area (FUPA), helping to reduce fat and tighten the skin for a more sculpted look. Each bottle contains 30ml of formula. Shipping not included. Price remains the same for pickup from Goals locations. - $499.00Lipo In A Bottle Cream (Inner Thighs) - Lipo In A Bottle Cream formulated to sculpt and slim the inner thighs, reducing the appearance of stubborn fat. Each bottle contains 30ml of formula. Shipping not included. Price remains the same for pickup from Goals locations. - $499.00Lipo In A Bottle Cream (Knees) - Lipo In A Bottle Cream designed to smooth and contour the knee area, targeting fat deposits for a more refined look. Each bottle contains 30ml of formula. Shipping not included. Price remains the same for pickup from Goals locations. - $499.00
MediFlex Program

One (1) Month MediFlex Program (Lab Tests Required) - Achieve your weight loss goals with the Mediflex Weight Loss Program. Start with a medical history review and a consultation with a licensed physician to ensure you're a good candidate for Semaglutide injections. Benefits include reduced hunger, increased fullness, and preventing weight regain. With once-a-week injections, guidance on nutrition and exercise, and regular check-ins, you'll have all the support you need.Delivered within 3-8 days. - $570.00One (1) Month Tirzepatide (Mounjaro) Program (Lab Tests Required) - Experience effective weight loss with the Tirzepatide (Mounjaro) Program. Start with a medical consultation to ensure suitability. Benefits include significant weight reduction and improved metabolic health. Includes guidance on nutrition and exercise, and regular check-ins. - $900Pick Up Only: One (1) Month MediFlex Program (Lab Tests Required) - Save time and money by picking up your Semaglutide and B6/B12 injections at a Mediflex location. This option includes a 4-week supply for self-administration. Select your pick-up location below. - $570.00Three (3) Month Semaglutide Program (Lab Tests Required) - Get a comprehensive 3-month MediFlex weight management program with Semaglutide and B6/B12. Shipping not included. - $1,500.00Three (3) Month Tirzepatide Program (Lab Tests Required) - Get a comprehensive 3-month MediFlex weight management program with Tirzepatide. Shipping not included. - $2,350.00Pick Up Only: Three (3) Month MediFlex Program (Lab Tests Required) - Pick up a 3-month supply of Semaglutide and B6/B12 injections at a Mediflex location, saving time and money. Select your pick-up location below. - $1,500.00Two (2) Months MediFlex Drops (Lab Tests Required) - Transform your weight loss journey with the MediFlex Drops Weight Loss Program. With personalized medical support and cutting-edge oral Semaglutide, you'll gain a whole new lifestyle. - $999.00One (1) Month Skinny Pills Weight Loss Program - A month’s supply of Skinny Pills designed to reduce hunger, increase fullness, boost energy, and support overall health. Includes a medical consultation, personalized nutrition and exercise guidance, and regular check-ins. Fast delivery. - $250.00
Pick Up Location
Select Your Addons Below:

Lipo-C Injections Home Kit (Rx 30 Day Supply) - This home-kit includes home-administered prescription weight loss injections, designed to help you reach your weight loss goals in a convenient and safe manner. These injections contain a combination of active ingredients, including methionine, inositol, choline chloride, and thiamine HCL, to promote effective weight loss. The formula is specifically designed to boost your metabolism and support healthy weight management. 7-10 Days for delivery. Shipping not included. - $349.00B12 Injection Home Kit (Rx 30 Day Supply) - This home kit includes a 30 day supply of B12 injections. The purpose of our Vitamin B12 Shot is to improve energy levels, boost metabolism, help burn fat and aid in deficiency. This product requires a prescription.7-10 Days for delivery. Shipping not included. - $275.00SlimPop Rx Supplement (Rx 120 Capsules) - SlimPop RX is a prescription-only supplement designed to support weight loss and overall health. Each bottle of SlimPop RX contains 120 capsules, providing a 4-month supply when taken once daily.The active ingredients in SlimPop RX include:Inositol: Supports metabolism and helps regulate insulin levels. Choline Bitartrate: Essential for liver function and fat metabolism. Methylcobalamin: An active form of vitamin B12 that promotes energy production; Chromium Picolinate: A mineral that can help regulate blood sugar levels and support weight loss. Prescription required. Shipping not included. - $349.00
Payment Details

Complete your payment with your payment information.
Name on Card*
Card Number*
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Expiration Date*

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Date
Upload your ID Photo*

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Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
To complete your order efficiently, please take a moment to fill out our credit card authorization form. This additional step ensures a secure and smooth transaction process. Rest assured, your information will be handled with the highest confidentiality. If you have any questions, our support team is here to assist.

Refund Policy Your payment will not be charged until your order is processed by our team. By submitting payment, you agree to the refund policy: it is very difficult for MediFlex Weight Loss to accurately predict the actual damages that would stem from patient’s cancellation of the treatment/procedure on the date agreed upon, therefore, if the patient cancels their treatment/procedure for any reason, other than for medical necessity, the patient will forfeit any and all of the fees that patient has paid toward the treatment/procedure as of the date of cancellation, including the initial fee, all interim amounts, and all amounts paid toward laboratory fees/bloodwork.
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Personal Details

Initial Health Assessment

Order Details

Payment Details