Start Your Journey

Which area of your health are you ready to Reclaim?*

Weight LossWomen’s Hormone Replacement TherapyMen’s Hormones Replacement Therapy

GLP-1 Weight Loss Pre-Screening

Let’s Find Out if RITSA Weight Loss is Right for You
What's your Name?*

First NameLast Name

What’s your email?*

What’s your phone number?*
Please enter a valid phone number.Format: (000) 000-0000.

What state do you live in? *

Which age group are you in?*

Under 1818–2425–3435–4445–5455+

Have you tried to lose weight in the past 6 months?*

YesNo

What is your current height and weightt?

Do you have any of the following conditions? *

Type 2 DiabetesPCOSHigh blood pressureNone of the above

Are you currently taking any weight loss medications?*

NoYes
Which one?

Have you ever had any of the following conditions or are you currently pregnant or breastfeeding? *

PancreatitisMedullary thyroid cancer (MTC)Multiple endocrine neoplasia type 2 (MEN2)Currently pregnant or breastfeedingNone of the above

Your safety is our top priority. Because of your medical history, RITSA may not be able to prescribe GLP-1 weight loss medications. Please speak with your healthcare provider before considering this option.

What are your top health goals right now? *

Lose weightBalance hormonesImprove energyFeel confident againAll of the above

Women’s Hormone Therapy (HRT) Pre-Screening

Rebalance Your Hormones, Reclaim Your Energy
What’s your name?*

First NameLast Name

What’s your email?*
example@example.com

What’s your phone number?*
Please enter a valid phone number.Format: (000) 000-0000.

4. What state do you live in? *

Which age group are you in?*

Under 1818–2425–3435–4445–5455+

Are you currently pregnant or breastfeeding?*

NoYes

Are you currently on any hormone therapy?*

YesNo

Have you experienced any of the following symptoms?*

Hot flashesLow libidoNight sweatsMood swingsIrregular periodsVaginal drynessWeight gainPoor sleep

Have you had a hysterectomy?*

YesNo

Your safety is our top priority. For this reason, RITSA does not prescribe hormone therapy during pregnancy or breastfeeding.

Have you gone 12+ months without a period(menopausal)?*

YesNo

Men’s Hormone Therapy (HRT) Pre-Screening

Is Low Testosterone Holding You Back?
Name*

First NameLast Name

What’s your email?*
example@example.com

What’s your phone number?*
Please enter a valid phone number.Format: (000) 000-0000.

5. What state do you live in?*

Which age group are you in?*

Under 1818–2425–3435–4445–5455+

Are you currently using testosterone therapy?*

YesNo

Are you experiencing any of the following? *

FatigueLow libidoErectile changesWeight gainMuscle lossMood swingsTrouble concentrating

Thanks for your interest! At this time, RITSA is only available for adults 18 and older. We’d love to support you when the time is right.

"We’re not in your state yet—but RITSA is growing! You’ve been added to our waitlist and you’ll be the first to know when we launch in your area."

4. What state do you live?
Final Name

First NameLast Name
Final Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Have you ever been diagnosed with low testosterone or had labs showing low T?*

YesNo
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