Onboarding Funnel — Flow Diagram

All 5 steps with the actual questions & answer options.

New Patient Application — 5-Step Funnel

Physicians Weight Control · Online intake

What brings you in?

Pick the goal that fits best. You can change it later.

Single choice

Choose your goal

GLP-1 medication — Semaglutide or tirzepatideMedical weight loss — Diet program with a physicianStrawberry laser contouring — Non-invasive inch lossBoth / not sure — We'll help you decide

Tell us where you are today

This helps your physician plan a healthy, realistic goal.

Number inputs

Height

FeetInches

Current weight (lbs)

Goal weight (lbs)

Waist size (optional)

e.g. 34

BMI (auto-calculated from height & weight)

A few lifestyle questions

There are no wrong answers. We'll meet you where you are.

Single choice

Do you drink 8 glasses of water a day?

YesNo

How many days a week do you exercise?

0 days1-2 days3-4 days5+ days

Which best describes your eating habits?

I skip mealsI snack a lotI eat out oftenFairly balanced

Any health conditions?

Select any that apply. Your answers stay private and go only to your care team.

Multi-select (check all that apply)

Health conditions

Any form of cancerHeart diseaseHigh cholesterolGallbladder/liver/kidney problemsIBS or colitisSeizures or strokeBehavioral or emotional problemsHigh blood pressureSkin pigmentation disorderI smokeInsulin-dependent diabetesPacemakerPregnant or nursingNone of these

Where should we reach you?

Choose your office and we will contact you to schedule your first visit.

Text inputs + choice

First name

Last name

Phone

Age

Sex

FemaleMale

Preferred contact method

PhoneEmailText

Choose your office

MediaKing of PrussiaAllentownPottstownBristolKennett Square

Submit application

✓

Application received

We'll contact you to schedule your first visit.