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ThinGevity Pre-Intake Qualifier

Short qualifier before checkout. Passing this form does not guarantee a prescription or final medical approval.

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Pre-Intake Questions

Are you over 18?(Required)
Are you currently pregnant or breastfeeding?(Required)
Do you have a personal or family history of any of the following? Pancreatitis, kidney, liver, or gallbladder disease, Type 1 diabetes, diabetic retinopathy, severe gastroparesis, medullary thyroid cancer (MTC), MEN2, or an eating disorder.(Required)

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