Contact Contact Us Help Us Gather Data About Your Semaglutide Experience: Last Name (Optional) First Name (Optional) Date of Birth (Optional) Sex (Optional) Female Male Email (Optional) This is my weight loss journey: Skip Rybelsus Ozempic/Wegovy Mounjaro/Zepbound How Long Did You Continue? Skip 1 Month 1-3 Months 3-6 Months >6 Months My weight loss experience Skip I had to quit due to side effects I adjusted after early side effects I am able to keep my weight down after stopping I regained my weight after stopping How Much Weight Did You Loose? Skip 5-10 Pounds 10-15 Pounds 15-20 Pounds 20-25 Pounds 25-30 Pounds >30 Pounds My Insurance Status: Select One Skip I have Commercial or Private Insurance with Drug Coverage I have State or Federal Insurance I have Medicaid I have Medicare I have no Insurance My Starting BMI (Optional) My Ending BMI (Optional) My Starting A1C (Optional) My Ending A1C (Optional) Suggestions/Comments: Send
