Semaglutide / Tirzepatide Telehealth Visit Request Form

For Texas Residents Only

After completing the form you will recieve a text message link to a FREE telehealth visit to be evaluated for semiglutide weght loss therapy. If the physcian deems the medication appropriate your prescription will be sent to Cody Drug in Sulphur Springs, TX.

If you are a resident of Sulphur Springs please select "Local Pickup" below.

If you live anywhere else in the State of Texas please select "Ship To Home" and we will overnight the medication (on ice) to the address on file.

Once we recieve the prescription we will give you a call to confirm details and collect payment before filling the prescription. If you have questions feel free to give us a call at 903-885-2639.

WE CAN NOT BILL INSURANCE OR MEDICARE OR MEDICAID FOR THIS MEDICATION. 

Please only submit this form if you are willing to pay out of pocket for the medication

 

Compound Options

Semiglutide Injections 

Price:

Month 1 & 2: $450 (total)

Month 3&4: $600  (total)

Maintenence $650 (total)

 

Semiglutide Sublingual (under the tounge drops)

Price:

Month 1 - 3: $250 (each month)

Month 4 & After: $285 (each month)

 

Tirzepatide Injections

Price

Month 1 - 4: $550/month

Month 5 - 6: $850/month

COMPOUNDED INJECTABLE MEDICATION FOR WEIGHT LOSS

The usage of GLP-1 and GIP receptor agonists has grown worldwide. This class of medication includes several different injectable medications, Semaglutide (Ozempic®, Wegovy®) and Tirzepatide (Mounjaro®, Zepbound™). High demand has pushed these medications onto the FDA’s Drug Shortage List. As a result, the FDA has issued guidance for compounding pharmacies to help address the shortage by making essential copies of the patented drugs, for as long as the drugs remain on the FDA’s Shortage List.

 

Compound Options

Semiglutide Injections 

Price:

Month 1 & 2: $450 (total)

Month 3&4: $600  (total)

Maintenence $650 (total)

 

Semiglutide Sublingual (under the tounge drops)

Price:

Month 1&2: $250 (total)

Month 3 & After: $285 (each rx)

 

Tirzepatide Injections

Price

Month 1 - 4: $550/month

Month 5 - 6: $850/month