Eligibility Check

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Eligibility Check

Answer a few quick questions to find out if Obeon is right for you — it takes about a minute

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First Name *

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Age *

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State of Residence *

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Email *

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Phone Number *

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How did you hear about us? (check all that apply) *

Online Search

Google or Meta Ad

Instagram

TikTok

YouTube

Facebook

Friend or Family Referral

Healthcare Provider Referral

Employer Benefit

Other (Please Specify)

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Please Specify (Optional)

Height *

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Unit *

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Current Weight *

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Unit *

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Weight-related comorbid conditions (check all that apply) *

Hypertension

Dyslipidemia

Prediabetes

Type 2 Diabetes

Obstructive Sleep Apnea

Polycystic Ovary Syndrome (PCOS)

Nonalcoholic Fatty Liver Disease (NAFLD)

Joint Pain or Osteoarthritis

Other (Please Specify)

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Please Specify (Optional)

Medical history (check all that apply) *

Medullary Thyroid Carcinoma (Personal or Family History)

Multiple Endocrine Neoplasia Type 2 (MEN2)

Pancreatitis

Severe Gastrointestinal Disease

Active Eating Disorders

Pregnancy or Breastfeeding (Current or Planning To)

Hypersensitivity to Tirzepatide (Zepbound) or its ingredients

Hypersensitivity to Semaglutide (Wegovy) or its ingredients

None of the Above

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I confirm the information above is accurate to the best of my knowledge *

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Full Name *

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Email *

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Phone Number *

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Message *

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