Medical Track Intake

From conversation
to your front door.

A licensed physician will review what you share here and decide whether the Medical Track is right for you. Takes about 6 minutes. Your information stays private.

This is a request, not a guarantee. The physician makes the medical decision — they may approve, modify, or decline.
Wellness coaching is free. If you and your coach decide the Medical Track is the right fit, the medical group collects a separate physician review fee at that point — refunded if you're not approved.
HIPAA-aligned handling. Data is encrypted in transit and stored securely. Used only for your medical review.
You can pause anytime. Use a private device. We'll never share your information.

Step 01 of 10

What's your primary goal?

Pick the one that's most front of mind. Your wellness coach will refine this with you later.

Fat loss & metabolic GLP-1 protocols, body composition

Recovery & joint BPC-157, TB-500, healing support

Energy & focus NAD+, Sermorelin, cognitive support

Healthy aging & longevity GHK-Cu, MOTS-c, glutathione

Step 02 of 10

Let's start with your basics.

Your legal name as it appears on ID. Used by the prescribing physician and pharmacy.

First name*

Last name*

Date of birth*

Sex assigned at birth*

State of residence*

Telehealth licensing is state-specific. Some states require additional steps.

Step 03 of 10

Body metrics.

Your physician uses these for protocol design. Be honest — there's no judgment here.

Height*

Current weight (lbs)*

Goal weight (lbs)

Optional — helps your coach map a realistic plan.

Step 04 of 10

Where can we reach you?

Email is for your coach. Address is where the pharmacy ships your medication, if approved.

Email*

Phone*

Street address*

Apt / suite

City*

ZIP*

Step 05 of 10

Medical history.

Check anything that applies — past or present. The physician needs the full picture to keep you safe.

Currently pregnant, breastfeeding, or trying to conceive Kidney disease (any stage) Liver disease or cirrhosis Active or past eating disorder Current or past suicidal ideation Cancer (active diagnosis or treatment) Pancreatitis (current or history) Organ transplant or anti-rejection meds Severe GI condition (gastroparesis, IBD) Personal/family medullary thyroid cancer or MEN-2 Heart disease, arrhythmia, or prior cardiac event High or low blood pressure Diabetes (Type 1 or 2) Thyroid disorder (other) Depression or anxiety (current treatment) None of the above

Anything else the physician should know?

Step 06 of 10

What are you curious about?

Tell us what you've researched or have been recommended. Your physician will recommend what's clinically appropriate — your selections aren't a guarantee of what's prescribed.

Fat loss & metabolic

Compounded Semaglutide · GLP-1 for weight management Compounded Tirzepatide · GLP-1/GIP for weight management MOTS-c · mitochondrial peptide for metabolic support Lipo-B / MIC+B12 · fat metabolism + energy

Recovery & joint

BPC-157 · tissue repair & gut healing TB-500 · soft tissue & muscle recovery Wolverine Stack · BPC-157 + TB-500 combo GHK-Cu · copper peptide for tissue & skin

Energy & focus

NAD+ injection · cellular energy & mental clarity Sermorelin · growth hormone support Glutathione · master antioxidant Semax / Selank · cognitive & mood support

Healthy aging & longevity

GHK-Cu · copper peptide for skin & longevity MOTS-c · mitochondrial longevity peptide Glutathione · master antioxidant & detox Sermorelin · growth hormone for healthy aging

Anything else you've researched or had recommended?

Have you used peptides or GLP-1s before?

Step 07 of 10

Medications & allergies.

Including supplements and any peptides you're already using.

Current medications & supplements

Write "none" if you're not taking anything.

Allergies (medications, foods, materials)

Note: nickel sensitivity is relevant for copper-based protocols (GHK-Cu).

Step 08 of 10

A bit about your lifestyle.

Helps your coach build a protocol that fits the life you actually live.

Average sleep per night

Exercise per week

Alcohol

Stress level

How did you hear about OS reboot?

Step 09 of 10

Required consents.

Read each one, then check to acknowledge. All four are required to submit.

Step 10 of 10

Review & submit.

Quick scan before it goes to the care team. Click any line to jump back and edit.

✓

You're in.

Your intake has been routed to the care team. A wellness coach will reach out within one business day to schedule a brief intro call and recommend a path forward — at no cost to you. If you and your coach decide the Medical Track is right for you, the next steps will be explained then.

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From conversationto your front door.