Eligibility Weight Loss Quiz

Eligibility Weight Loss Quiz

Take the short quiz to see if you qualify for a personalized GLP-1 weight loss plan. In just a few quick steps, we’ll determine if GLP-1 medications may be right for you. Your answers are secure, and your eligibility will be reviewed by a licensed Mint Med provider.
What's your weight loss goal?*

Up to 20lbs21-50lbs50+lbsNot sure yet

What are you hoping to improve by losing weight?*

My physical healthMy appearanceMy mental healthAll of the above

Phone Number*
Please enter a valid phone number.
Email*
example@example.com
What state do you reside in?*
By entering your phone number and checking the box below, you consent to Mint Med calling or sending text messages to you for the purpose of verifying your phone number, ensuring patient safety, and for any other lawful purposes related to your Mint Med account in use of our services. This includes cart/browser reminders, marketing promotions, order confirmations, shipment notifications, and messages from your provider. You must be 18 or older to opt in. Message and data rates may apply. Message frequency varies. Reply HELP for assistance or STOP to opt out.*

What was your starting weight in pounds? Please specify the weight in pounds (lbs). Example: 215 lbs.*
What's your current weight?*

BMI Consent
The traditional use of weight loss medications is for individuals with a BMI of 30 and above or to those who are overweight who have associated health conditions. Using it for someone with a BMI range (27-29) without an accompanying health condition is termed "off-label." Using a medication "off-label" refers to the practice of prescribing a drug for a purpose, age group, dosage, or form of administration that is not included in the approved labeling by regulatory agencies like the U.S. Food and Drug Administration (FDA). While a medication undergoes rigorous testing for specific uses before receiving approval, healthcare providers may discover through clinical experience or research that it can be effective for treating other conditions. There may be benefits such as weight reduction for individuals within your range. If you agree to this off-label use, it's crucial to follow the prescribed regimen and report any concerns. Please discuss any questions with us.
By checking this box, you acknowledge the above information

Do you take any of the following medications?*

None of the belowGlimepiride (Amaryl)Glipizide (Glucotrol & Glucotrol XL)Glyburide (Micronase, Glynase, & Diabeta)SitagliptinSaxagliptinLinagliptinAlogliptinInsulin

We’re sorry, but you don’t currently qualify for GLP-1 treatment.

Based on your responses, you do not meet the clinical criteria for this medication at this time.

If you believe this is an error or would like to explore alternative weight loss solutions, our team is here to help. Please contact us at help@mintmed.com to discuss your options.

Are you allergic to any of the following?*

No, none of theseMounjaro (Tirzepatide)Wegovy (Semaglutide)Zepbound (Tirzepatide)Saxenda (Liraglutide)Trulicity (dulaglutide)Ozempic (Semaglutide)

We’re sorry, but you don’t currently qualify for GLP-1 treatment.

Based on your responses, you do not meet the clinical criteria for this medication at this time.

If you believe this is an error or would like to explore alternative weight loss solutions, our team is here to help. Please contact us at help@mintmed.com to discuss your options.

How important is the ability to tailor your prescription experience to your individual preferences or needs?*

Very importantSomewhat importantNot important

Would nausea, vomiting, or diarrhea disrupt your daily routine?*

Yes, very disruptiveSomewhat disruptiveNot disruptive at all

Congratulations!It looks like you may be eligible for a personalized GLP-1 treatment plan based on your responses.