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WEIGHT MANAGEMENT RESTRICTIONS

Patients are ineligible for a controlled-substance appetite suppressant prescription and are subject to forfeiture of deposits for the following reasons:

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• Uncontrolled hypertension

• Active case of glaucoma

• Heart disease or dysfunction

• Active prescription for ADD, ADHD, Narcolepsy, Wakefulness, or Another Appetite Suppressant Rx

• UNQUALIFIED STATE OF RESIDENCY (e-visits)*

• Clinician determines such prescriptions are unsafe for unlisted medical reasons

• Patient has multiple prescribers for appetite suppressants

• Failure to appear for appointment or notify staff of inability to appear 24 or more hours prior to scheduled appointment (e-visits)

• Failure to appear for evisit appointment WITH required equipment (i.e. working blood pressure cuff, tape-measure, working scale, ID, payment)

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Semaglutide Restrictions

• Age under 18

• Pregnant or unsure if pregnant; breastfeeding

• Renal insufficiency (Kidney dysfunction); Kidney stones are NOT a contraindication

• Current substance abuse (prescription medications or illicit drugs)

• Active eating disorder (anorexia or bulimia)

• Current active cancer of any kind

• Bariatric surgery within the past 18 months

• Gallbladder dysfunction or active symptomatic gallstones

• Pancreatitis within the past 6 months

• Partial thyroid removal; complete thyroid removal is NOT a contraindication unless gland was removed secondary to thyroid cancer

• History of multiple endocrine neoplasia syndrome (MEN syndrome), medullary thyroid cancer (MTC), or any type of thyroid C-cell tumor

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Semaglutide Cautions

• Age 65 or older. Studies have not been done in this age group. Discuss with one of our clinicians to determine is Semaglutide is an appropriate option.

• ​Semaglutide can lower your blood glucose (can cause hypoglycemia). Discuss with one of our clinicians to determine is Semaglutide is an appropriate option.

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*PLEASE NOTE:

All patients will be subject to a (PMP) Prescription Management Program Check

as required by state-law.

REQUESTS FOR NARCOTIC MEDICATION(S) WILL NOT BE ENTERTAINED.