Physicians Weight Control
See if I qualify

Qualify Funnel — Flow Diagram

All 5 steps with the actual questions & answer options.

Qualify / CTA Funnel — 5-Step Patient Intake

Physicians Weight Control · Online qualifier

1

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
2

How would you like to receive care?

We offer in-person visits at our offices and virtual appointments online.

Single choice
Choose your care type
In-person care — Visit one of our officesVirtual care — Meet with us onlineNot sure — We'll provide guidance & help you decide
3

Let's get to know you

We'll verify your phone so we can reach you about your application.

Text inputs + OTP verification
First name *
Last name *
Email
Phone
Provide at least one contact method (email or phone)
Date of birth *
Gender
FemaleMaleNon-binary
Verify your phone or email (4-digit code)
Send code via SMSSend code via emailEnter code to verify
4

Current status & medical screening

This helps your physician plan a safe, effective program for you.

Number inputs + choices + multi-select
Height
FeetInches
Current weight (lbs)
Goal weight (lbs)
BMI (auto-calculated from height & weight)
Are you currently taking any prescription weight loss or diet medications?
YesNo
If yes — what medication?
Semaglutide (Wegovy/Ozempic)Tirzepatide (Zepbound/Mounjaro)PhentermineLiraglutide (Saxenda)ContraveQsymiaOther
If yes — current dose
e.g. 2.5 mg weekly
Health conditions (check all that apply — required for GLP-1 safety)
Insulin-dependent diabetesHeart diseaseHigh blood pressureHigh cholesterolGallbladder/liver/kidney problemsSeizures or strokeAny form of cancerPregnant or nursingNone of these
5

Schedule your consultation

Lock in your first visit now, or let us reach out to find a time.

Single choice + conditional inputs
Would you like to schedule your new patient consultation now?
Yes, let's book it nowNo / Not sure
If yes & in-person — choose your office
MediaKing of PrussiaAllentownPottstownBristolKennett Square
If yes & in-person — preferred date
If yes & in-person — preferred time
9:00 AM – 5:00 PM (30-minute slots)
If yes & virtual
Directed to telehealth sign-up (Semaglutide vs Tirzepatide)
If no
Onboarding specialist will text you to find a time
Submit application
✓
Application received
Appointment scheduled, or an onboarding specialist will reach out.