Tirzepatide Screener

Tirzepatide Eligibility Check – Revana

Revana.

Confidential Screening

Eligibility Check

Step 1 of 8

Compounded Tirzepatide · Eligibility Check

Let's confirm Tirzepatide is right for you.

This quick 2-minute screening checks your eligibility based on our physician network's clinical guidelines. Your answers are confidential and not stored.

8 short questions
Instant eligibility result
Proceed to checkout only if you qualify
No personal health data stored at this stage

Basic Eligibility

Question 1 of 7

Are you 18 years of age or older?

GLP-1 therapy is only available to adults 18 and over.

Basic Eligibility

Question 2 of 7

Let's check your BMI eligibility.

GLP-1 medications typically require a BMI of 27 or higher, however our physicians will review patients with a BMI of 23 or above. Enter your measurements below.

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Enter measurements

BMI calculates automatically

Weight (lbs)*

Height*

Safety Screening

Question 3 of 7

Are you currently pregnant, breastfeeding, or actively trying to conceive?

Safety Screening

Question 4 of 7

Do any of the following apply to your cancer history?

Select all that apply.

Safety Screening

Question 5 of 7

Have you experienced any of the following in the past 6 months?

Select all that apply.

Safety Screening

Question 6 of 7

Have you been diagnosed with any of the following?

Select all that apply.

Safety Screening

Question 7 of 7

Do you have any known allergies to the following?

Select all that apply.

We're unable to proceed at this time.

Reason

Based on your responses, our physician network is unable to prescribe GLP-1 therapy at this time. This decision is based on clinical safety guidelines — not a personal judgment. We encourage you to speak with your primary care provider about your options.

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You're eligible!

Great news — you qualify. Select your plan below to proceed to secure checkout.

Choose your plan

1 Month Supply

Starter plan · Billed once

$199

3 Month Supply

Best value · $100 savings

$497

Save $100

Your full intake form is completed after payment. Final approval by physician.