Semaglutide Inquiry Form

Please fill out the questionnaire below. You will then receive instructions on how to proceed.
Please note we require a consultation with a medical professional, either on site or through our zoom app before prescribing any medications.
Semaglutide Inquiries
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Interest and Awareness:

Have you ever used any GLP-1 receptor agonists before?

Health Overview:

Are you currently taking any medications or supplements?
Do you have a history of thyroid cancer or a family history of medullary thyroid carcinoma?
Have you ever been diagnosed with pancreatitis?

Lifestyle Questions:

Expectations and Consent:

Are you aware of the potential side effects and agree to consult with a healthcare professional before starting treatment?

Get in Touch

Check out the other services at our Ridgefield Medspa


228 Simons St
Ridgefield, WA 98642



(360) 513-6095



Monday – Friday: 9 am – 7:00 pm

Saturday: 11 am – 5:00 pm

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