Check-In Form

Have you taken your medication as prescribed?

Have you experienced any difficulties using the injection?

Where have you been injecting the medication? (Select all that apply)

Please select any symptoms you are experiencing (Select all that apply)

Are your side effects tolerable?

Do you need support from a clinician regarding side effects?

Have you been able to follow the recommended diet plan?

Have you noticed any changes in your appetite?

Any new or worsening medical conditions?

Have there been any changes to your medications or supplements?

How would you like to continue with the program? (Select one)

Have your goals or expectations changed since you started the program?