This screening helps organize information your provider may need
before determining whether a GLP-1 or another weight-management
pathway may be appropriate.
BasicBodyHealthMedsSafety
Basic & reproductive health
Only information needed for initial screening is requested here.
CharmHealth will collect official demographics if you proceed to scheduling.
Reproductive Health
Your provider may need to discuss contraception when selecting a medication.
Body measurements
Use the controls below. BMI is calculated automatically.
Height — Feet
5
feet
Height — Inches
6
inches
Current Weight
200
pounds (lb)
Goal Weight — Required
170
pounds (lb)
Estimated BMI:
—
Medical history
These conditions help your provider interpret your weight-management options.
Medication history
This information helps identify duplicate medications,
medication risks and previous medication response.
Diabetes Medications
Safety review
These answers help identify situations that require additional provider review.
Secure Clinical Queue
Secure Provider Review Request
This secure request is sent directly to the Florida Sunset Healthcare Clinical Review Queue. It is separate from the general website contact form.
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Enter the four-digit year directly — no calendar scrolling.
