Monthly Check-in

    Your monthly check-in for Tirzepatide

    A few quick questions about how your current dose is going. Your provider reviews your answers before your next shipment.

    What's your email?

    Use the email from your Levers order.

    What's your current weekly Tirzepatide dose?

    The dose you inject once a week. Not sure? Pick the closest one and tell us in the note at the end.

    2.5 mg per week
    5 mg per week
    7.5 mg per week
    10 mg per week
    12.5 mg per week
    15 mg per week

    Have you taken your dose every week?

    Yes, every week
    I missed 1 or 2 doses
    I missed more than 2 doses
    I haven't started yet

    How are you feeling on your current dose?

    Great, no side effects
    Mild side effects I can manage
    Side effects are hard to manage

    Which side effects have you noticed?

    Select all that apply.

    Nausea
    Constipation
    Diarrhea
    Heartburn or reflux
    Fatigue
    Injection site reaction
    Severe stomach pain or vomiting that won't stop
    Other (tell us in the note)

    How has your weight loss been this month?

    Losing weight rapidly
    Losing weight slowly
    Plateau

    What would you like for your next shipment?

    After at least 2 weeks, if you've been consistent and you're tolerating your dose well, you can typically move up a step. Your provider reviews every request.

    Keep my current dose
    Increase my dose
    Lower my dose
    Skip my next shipment
    Cancel my plan

    Cancel your Tirzepatide plan?

    Cancelling stops your future shipments. If you pause for more than 6 weeks, you'll restart at a lower dose for safety.

    Yes, cancel my plan
    No, keep my plan

    Anything you want your provider to know?

    Optional. Questions, symptoms or anything that changed since your last shipment.

    Review your check-in

    Check-in sent

    Thanks for checking in

    Sending your check-in