Skip to main content

Affiliate disclosure: We may earn a commission if you buy through links on this site — at no extra cost to you. Thanks!

Educational Guide · Last verified: May 8, 2026

What a Good GLP-1 Telehealth Intake Should Ask: 35-Question Checklist (2026)

By WPG Research Team · · Educational guide, not individualized medical advice.

The right GLP-1 telehealth intake questions cover seven areas: who you are and where you're located, BMI and treatment goal, FDA-label contraindications (personal or family history of medullary thyroid cancer, MEN2, and prior serious allergic reaction to the drug or its ingredients), pregnancy and breastfeeding screening, FDA warning areas (pancreatitis, gallbladder disease, severe stomach issues, kidney risk, diabetic retinopathy), every medication you take, and prior GLP-1 use. If your intake missed most of those, the screening wasn't doing what FDA labels and clinical guidelines say it should.

Quick check before you scroll

What a serious GLP-1 intake should coverWhy it matters in one line
Identity, state, and telehealth consentThe clinician must be licensed where you are.
Height, weight, BMI, and treatment goalEligibility for FDA-approved use.
Thyroid cancer (MTC), MEN2, and serious allergy historyThese are FDA-label contraindications across every major GLP-1 brand.
Pregnancy, planning, breastfeeding, and current GLP-1 useThese should pause the standard flow for clinician review.
Pancreatitis, gallbladder, severe stomach issues, kidney riskThese are FDA warning areas, not just notes.
Every prescription, OTC, and supplementInsulin, sulfonylureas, and oral birth control change the plan.
Pharmacy source, FDA-approved vs. compounded, total costWhat FDA enforcement letters in 2026 said many programs are missing.

If your intake checked all seven boxes, you can probably move forward. If it missed three or more, keep reading. We're going to give you the full 35 questions, a way to grade your provider, and a copy-paste script you can send them before you take your first dose.

The 35 GLP-1 Telehealth Intake Questions a Safe Provider Should Ask

A clinically responsible GLP-1 telehealth intake covers 35 specific items grouped by risk level. Items 8–10 are FDA-label contraindications — a "yes" can stop the standard flow. Items 11–21 are stop-and-review questions where the answer may not mean "never," but a real prescriber needs to weigh risks before you start. The rest cover identity and licensure, eligibility, medication interactions, prior GLP-1 use, informed consent, and continuity of care.

How to read the "Missing this means…" column: "Automatic exclusion" means the FDA label lists the issue as a contraindication for that drug. "Clinician review" means it is not a flat no, but a real prescriber needs to weigh the risks before you start. "Monitoring" means treatment may still be possible, but the intake should not leave the issue unhandled.

Identity, location, and telehealth setup

#What the intake should askWhy it mattersMissing this means…
1Your legal name, date of birth, and how to reach youWithout this, no real medical record exists.Operational red flag
2Where you are physically located right now (state)A clinician must be licensed in your state to prescribe to you. HHS Telehealth states that the visit takes place in the state where the patient is physically located, and providers must meet that state's practice requirements.Legal and clinical red flag
3Your consent to receive care by telehealth and what its limits areHHS Telehealth and the Federation of State Medical Boards both treat documented telehealth consent as part of the standard of care.Quality and legal red flag

Eligibility and treatment goal

#What the intake should askWhy it mattersMissing this means…
4Your current height, weight, and BMIWegovy and Zepbound are approved for adults with obesity, or with overweight plus a weight-related condition.Clinical red flag
5What condition you are seeking treatment for (weight loss, type 2 diabetes, sleep apnea, cardiovascular risk reduction)GLP-1 medications do not all share the same FDA-approved uses. Wegovy is approved to reduce cardiovascular risk in eligible adults; Zepbound is approved for moderate-to-severe obstructive sleep apnea in adults with obesity.Clinical red flag
6Weight-related conditions you have — high blood pressure, high cholesterol, sleep apnea, heart disease, prediabetes, type 2 diabetesThese determine which medication and which indication apply.Clinical red flag
7Your weight history, prior weight-loss attempts, and what worked or didn'tThe Obesity Medicine Association's 2026 algorithm calls for evaluation of weight history, complications, and prior treatments before starting therapy.Quality red flag

FDA-label contraindications (the "automatic exclusion" bucket)

These are the questions where a "yes" can stop the standard intake flow. MTC, MEN2, and serious hypersensitivity to the active ingredient or its excipients are listed as Section 4 contraindications across the mainstream GLP-1 brand labels.

#What the intake should askWhy it mattersMissing this means…
8Have you, or has any blood relative, had medullary thyroid cancer (MTC)? MTC is a rare cancer of the thyroid gland.Wegovy and Zepbound prescribing labels list personal or family history of MTC as a contraindication.🛑 Major safety red flag
9Have you ever been diagnosed with Multiple Endocrine Neoplasia syndrome type 2 (MEN2)? MEN2 is a rare inherited condition that raises the risk of certain tumors.MEN2 is a contraindication on every mainstream GLP-1 label.🛑 Major safety red flag
10Have you ever had a serious allergic reaction (anaphylaxis, angioedema, widespread hives, swelling, difficulty breathing) to this medication, its active ingredient, or one of its ingredients?Serious hypersensitivity is a Section 4 contraindication on the Wegovy and Zepbound labels. A serious reaction to a different GLP-1 should still trigger clinician review, not a checkbox approval.🛑 Major safety red flag

Stop-and-review questions (the "clinician review" bucket)

These are not automatic exclusions. What they share: a "yes" answer should pause the standard approval flow until a real prescriber reviews the risk and the plan.

#What the intake should askWhy it mattersMissing this means…
11Are you pregnant, trying to become pregnant, or breastfeeding?Wegovy labeling tells patients to stop at least two months before a planned pregnancy and to inform the provider about pregnancy plans or breastfeeding. Pregnancy is treated as a special-populations risk question across GLP-1 labels.🛑 Major clinical red flag
12Are you currently using another GLP-1 medication, or any product that contains semaglutide, tirzepatide, or liraglutide?Wegovy and Zepbound labeling says coadministration with other GLP-1 receptor agonists or other products with the same active ingredient is not recommended.🛑 Major safety red flag
13Have you ever had pancreatitis? Pancreatitis is severe inflammation of the pancreas, usually causing severe stomach pain.GLP-1 labels include acute pancreatitis warnings and instruct discontinuation if pancreatitis is suspected.Clinician-review red flag
14Have you had gallstones, gallbladder removal, or right-upper-belly pain after fatty meals?FDA labels include acute gallbladder disease as a Section 5 warning.Clinician-review red flag
15Do you have severe stomach disease, gastroparesis, or persistent vomiting? Gastroparesis is a condition where the stomach empties too slowly.The Zepbound label states it is not recommended for patients with severe gastroparesis.Clinician-review red flag
16Do you have kidney disease, or have you ever had a kidney injury after vomiting or diarrhea?GLP-1 labels include acute kidney injury warnings, often tied to dehydration from gastrointestinal side effects.Clinician-review red flag
17Do you have liver disease, a history of hepatitis, or recent abnormal liver tests?Liver history isn't a core Section 5 GLP-1 warning, but it matters for overall obesity and metabolic-risk assessment.Clinician-review red flag
18Do you have diabetic retinopathy, or have you noticed new vision changes? Diabetic retinopathy is eye-blood-vessel damage caused by diabetes.The Wegovy and Zepbound labels include diabetic retinopathy concerns in patients with type 2 diabetes when blood sugar drops quickly.Clinician-review red flag
19Do you have a history of depression, suicidal thoughts, suicide attempts, or major mood changes?In January 2026, the FDA requested removal of the suicidal behavior and ideation warning from Saxenda, Wegovy, and Zepbound labels after a meta-analysis of 91 trials and more than 107,000 patients found no increased risk. Mental health still belongs in a serious obesity-care intake.Clinician-review red flag
20Do you have surgery, anesthesia, or any procedure with sedation coming up in the next few weeks?The Wegovy and Zepbound labels both list pulmonary aspiration risk during general anesthesia or deep sedation as a Section 5 warning.Clinician-review red flag
21Have you ever been treated for an eating disorder — anorexia, bulimia, or binge eating disorder?The 2025 joint advisory from OMA, ACLM, ASN, and The Obesity Society lists disordered eating screening as part of baseline GLP-1 evaluation.Clinician-review red flag

Medication interactions

GLP-1 labels flag several medication-safety checks. The highest-signal ones are insulin, sulfonylureas, oral hormonal birth control with tirzepatide, and drugs where absorption timing matters.

#What the intake should askWhy it mattersMissing this means…
22Do you take insulin?GLP-1 labels warn about hypoglycemia (low blood sugar) when used with insulin; insulin doses may need to be reduced or monitored when starting a GLP-1.🛑 Major medication-safety red flag
23Do you take a sulfonylurea (glipizide, glyburide, glimepiride) or any other diabetes medication?Same hypoglycemia concern; the dose may need to be lowered.🛑 Major medication-safety red flag
24Please list every prescription medication you currently take.Without a complete list, no real interaction check happens.Medication-safety red flag
25Please list every over-the-counter medication, vitamin, and supplement you take.The label-specific concern is delayed stomach emptying, which can change how some oral medicines are absorbed. OTC products and supplements still belong on the list.Medication-safety red flag
26Do you take oral hormonal birth control?The Zepbound and Mounjaro labels advise switching to a non-oral contraceptive method or adding a barrier method for four weeks after starting and for four weeks after each dose increase, because tirzepatide can reduce oral contraceptive effectiveness.🛑 Major medication-safety red flag
27Do you take warfarin or another medication where blood-level timing matters?GLP-1 drugs delay stomach emptying, which can change how oral medications are absorbed; the Zepbound label calls this out specifically.Medication-safety red flag

Prior GLP-1 use

#What the intake should askWhy it mattersMissing this means…
28Have you previously taken Ozempic, Wegovy, Mounjaro, Zepbound, Saxenda, Rybelsus, or a compounded version of semaglutide or tirzepatide?Prior dose, recent use, and side effects all change the right starting plan.Clinical red flag
29What was your last dose, when did you last take it, and why did you stop?Restarting at the wrong dose can sharply increase gastrointestinal side-effect risk because GLP-1 starting schedules are designed to begin low and escalate gradually.Clinical red flag

Informed consent and treatment plan

These are not screening questions you answer — they are things a serious provider should tell you during intake.

#What the intake should discloseWhy it mattersMissing this means…
30Whether the medication is FDA-approved or compounded, and what that difference meansThe FDA's March 3, 2026 warning letters to 30 telehealth companies cited false or misleading compounded-GLP-1 marketing — including claims implying sameness with FDA-approved products and obscured product sourcing. Disclosure clarity is now an active enforcement priority.🛑 Major transparency red flag
31The starting dose and dose-escalation scheduleThe mainstream GLP-1 products use product-specific starting doses and gradual escalation. You should know yours up front.Quality red flag
32The warning signs to watch for and what to do — severe stomach pain, persistent vomiting, signs of an allergic reaction, signs of low blood sugarPatient counseling sections of GLP-1 labels include serious symptom topics such as pancreatitis, gallbladder symptoms, dehydration and kidney problems, allergic reactions, and surgery/anesthesia warnings.Quality and safety red flag
33A plan for what happens if you stop the medicationThe 2025 OMA joint advisory addresses discontinuation and weight maintenance as part of comprehensive care. Programs with no plan for stopping are giving incomplete care.Quality red flag

Operational and continuity of care

#What the intake should provideWhy it mattersMissing this means…
34A clear way to reach a clinician — not just a chatbot or generic FAQ — for urgent side effectsA program that cannot tell you how a real side effect reaches a real clinician has a structural quality problem.Quality and safety red flag
35A complete written cost breakdown — visit fee, medication, shipping, refill cadence, and what changes if you need a higher dose"From $99/month" without telling you what dose, what duration, what ships, what refills cost, and what happens at higher doses isn't enough information to consent financially.Trust red flag

The Three-Bucket Framework: Automatic Exclusion vs. Clinician Review vs. Monitoring

Not every "yes" answer to a screening question means you cannot take a GLP-1. We sort answers into three buckets: automatic exclusion (the FDA label lists the issue as a contraindication), clinician review (a real prescriber needs to weigh risks and adjust the plan), and monitoring (you can usually proceed but with a watch plan). The biggest mistake patients make when reading red-flag articles is assuming everything is in bucket one. Most isn't.

BucketExamplesWhat it means for you
🛑 Automatic exclusionPersonal or family history of MTC; MEN2; serious allergic reaction to the same drug, active ingredient, or excipientsThe FDA label lists the issue as a contraindication. A provider should not approve through a standard intake flow.
⚠️ Clinician review neededPregnancy, planning pregnancy, breastfeeding, current use of another GLP-1, past pancreatitis, gallbladder disease, severe stomach disease, kidney disease, diabetic retinopathy, history of depression or major mood changes, upcoming surgery, eating disorder history, insulin or sulfonylurea use, oral birth control use with tirzepatideThe answer may not mean "never," but it should pause the standard flow until a real prescriber reviews the risk and the plan.
📋 Monitoring or counselingCommon stomach side effects, dose-escalation timing, nutrition during treatment, missed doses, follow-up cadenceNot disqualifying, but should be addressed openly during intake.

If a provider treats every "yes" as automatic exclusion, you'll be denied for things that don't actually require denial. If a provider treats nothing as automatic exclusion, you've got a vending machine, not a clinic. The right pattern is: ask everything, then sort.

How to Grade Your Intake (a 10-Minute Self-Audit)

Score each of the 35 items as either covered (1 point) or missing (0 points) for a total out of 35. Open the form (or your email confirmation) and walk through the 35 items above.

ScoreWhat it suggests
30–35 (≥86%)Serious intake. The big safety, medication, and continuity-of-care areas are covered. Move on to provider quality, cost, and fit.
20–29 (57–85%)Borderline intake. Some items are missing — usually medication interactions, prior GLP-1 dose details, eating disorder screening, or follow-up plan. Send the copy-paste script below before you start.
0–19 (<57%)Below this checklist's safety floor. The contraindication, medication, or continuity screening is incomplete. Pause and ask for a clinician review before you take a single dose.
Important: This score is a thinking tool, not a regulatory grade. A high score is not a safety guarantee. A low score does not mean the program is doing anything illegal. The score helps you ask better questions; it does not replace a clinician's judgment.

The 7 Biggest Red Flags in a GLP-1 Telehealth Intake

You don't need to memorize 35 items to spot a bad program. Just check for these seven:

1

Instant approval with no clinician review in between.

A real clinician review takes time. If a prescription appears in your inbox before a clinician could possibly have read your answers, that's a structural shortcut.

2

No thyroid cancer or MEN2 question.

Every mainstream GLP-1 label lists these as contraindications. If the form doesn't ask, the program skipped a Section 4 screening item.

3

No complete medication list collected.

The FDA labels for Wegovy and Zepbound both call out specific drug-interaction concerns. If you weren't asked, no interaction check happened.

4

No pregnancy question for women of reproductive age.

Pregnancy guidance is in every GLP-1 label.

5

Your only way to reach the clinician is a chatbot or generic FAQ.

A program that cannot tell you how a real side effect reaches a real clinician has a structural quality problem.

6

No disclosure of FDA-approved vs. compounded medication.

The FDA's March 3, 2026 warning letters to 30 telehealth firms specifically targeted programs that obscured this.

7

No written total cost.

"From $99/month" without telling you what dose, what duration, what ships, what refills cost, and what happens at higher doses isn't enough information to consent financially.

If three or more of these seven are present, the intake has failed at a structural level — not a detail level.

What FDA Labels Actually Say: A Brand-by-Brand Map

Every mainstream GLP-1 brand label — Wegovy, Zepbound, Ozempic, Mounjaro, Saxenda, Rybelsus — lists personal or family history of medullary thyroid cancer, MEN2, and serious hypersensitivity to the active ingredient or excipients as Section 4 contraindications. Here's the quick reference, pulled from current FDA prescribing information on accessdata.fda.gov and DailyMed.

Brand (active ingredient)Section 4 contraindicationsKey Section 5 warnings
Wegovy (semaglutide)MTC, MEN2, prior serious hypersensitivity to semaglutide or excipientsBoxed warning: thyroid C-cell tumors. Acute pancreatitis. Acute gallbladder disease. Hypoglycemia with insulin or insulin secretagogues. Acute kidney injury. Hypersensitivity. Diabetic retinopathy in T2D. Heart rate increase. Pulmonary aspiration during anesthesia.
Zepbound (tirzepatide)MTC, MEN2, prior serious hypersensitivity to tirzepatide or excipientsBoxed warning: thyroid C-cell tumors. Acute pancreatitis. Acute gallbladder disease. Hypoglycemia with insulin or insulin secretagogues. Acute kidney injury. Hypersensitivity. Severe gastrointestinal disease. Diabetic retinopathy in T2D. Reduced oral contraceptive effectiveness. Pulmonary aspiration during anesthesia. Never share KwikPen between patients.
Ozempic (semaglutide, T2D)MTC, MEN2, prior serious hypersensitivityBoxed warning: thyroid C-cell tumors. Pancreatitis. Diabetic retinopathy. Hypoglycemia. Acute kidney injury. Hypersensitivity.
Mounjaro (tirzepatide, T2D)MTC, MEN2, prior serious hypersensitivityBoxed warning: thyroid C-cell tumors. Pancreatitis. Hypoglycemia. Hypersensitivity. Acute kidney injury. Severe GI disease. Diabetic retinopathy. Acute gallbladder disease.
Saxenda (liraglutide, weight loss)MTC, MEN2, prior serious hypersensitivity, pregnancyBoxed warning: thyroid C-cell tumors. Pancreatitis. Hypoglycemia. Heart rate increase. Acute kidney injury.
Rybelsus (oral semaglutide)MTC, MEN2, prior serious hypersensitivitySame class effects as Ozempic in oral form.
Two recent label changes worth knowing about: In January 2026, the FDA requested removal of the suicidal behavior and ideation warning from Saxenda, Wegovy, and Zepbound labels after a comprehensive review of 91 clinical trials covering more than 107,000 patients found no increased risk. We re-verify these label sections quarterly and on each label revision.

For a deeper look at which patients should avoid GLP-1s entirely, see our complete GLP-1 contraindications guide.

The Compounded GLP-1 Question: What the Intake Must Disclose

If a telehealth program prescribes compounded GLP-1 medication, the intake must clearly state that the product is compounded, name the pharmacy, state the formulation and concentration, give exact dosing instructions, and explain that compounded medications are not FDA-approved. The FDA has identified dosing errors with compounded GLP-1 products, including cases that led to hospitalization. On March 3, 2026, the FDA issued 30 warning letters to telehealth firms over compounded GLP-1 marketing practices.

Disclosure itemWhy it matters
The exact medication name and form ("compounded semaglutide injection," not "our weight-loss medication")Avoids confusion about what you're taking.
Whether the product is FDA-approved or compoundedThis is the central question and FDA's main 2026 enforcement focus.
Whether the active ingredient is the same as the FDA-approved drugThe FDA has stated that some compounded products use forms the agency considers different active ingredients, including semaglutide sodium and semaglutide acetate.
The pharmacy name and whether it is a 503A traditional pharmacy or 503B outsourcing facilityThese are different legal categories with different oversight. You have a right to know which one.
Concentration and unitsMost compounded GLP-1 dosing errors trace back to confusion about units or volume.
Injection training (or video)Self-injection at the wrong dose is the documented harm pathway here.
Side-effect and overdose-symptom instructionsIf you mis-dose, you need to know what to watch for.
Refund, cancellation, and refill policySubscription terms remain a major complaint area.
On April 30, 2026, the FDA proposed excluding semaglutide, tirzepatide, and liraglutide from the 503B bulks list — finding no clinical need for outsourcing facilities to compound these drugs from bulk substances. As of this page's verification date, the comment period was still open, with comments due June 29, 2026. The legal space for mass-marketed compounded GLP-1 products has been narrowing throughout 2026.

For a detailed guide on spotting fraudulent compounded GLP-1 labels, see our GLP-1 pharmacy label red flags page — 18 checks before you inject.

Should a GLP-1 Telehealth Intake Require Lab Work?

No FDA prescribing label we checked makes baseline lab work a universal precondition for issuing a GLP-1 prescription. That doesn't mean labs never matter. The 2025 joint advisory from OMA, ACLM, ASN, and The Obesity Society recommends careful baseline assessment. The American Diabetes Association recommends HbA1c, kidney function, lipid testing, and eye care for patients with diabetes.

Lab work is risk-based, not universal. What separates good practice from bad practice isn't the lab itself. It's whether the intake is rigorous enough to substitute when labs aren't run.

Lab or vitalRecommended byWhen it should usually be ordered
HbA1cADA Standards of CareIf you have diabetes, prediabetes, or any sign of glucose abnormality.
Comprehensive metabolic panelOMA 2025 advisory; ADABest-practice baseline for many patients; especially if kidney or liver concerns.
Lipid panelADA, AACEBest-practice baseline; relevant for cardiovascular-risk discussions.
Thyroid functionOMA 2025 advisoryIf thyroid symptoms or family history.
Pregnancy testStandard practiceWhen clinically appropriate for women of reproductive age.
LipaseSelectiveIf pancreatitis history or current symptoms.

A program that says "no labs ever, no questions" is making a strong clinical statement that the intake is the entire safety screen. That's defensible only if the intake actually is rigorous. Use the 35-question checklist to find out.

What Should Happen After You Submit Your Intake

After you submit a GLP-1 telehealth intake, a licensed clinician should review your answers, follow up on anything that raised a flag, explain the medication, dose-escalation schedule, and side effects, and only then issue a prescription if treatment is appropriate. The intake form is the information-gathering step. It is not the medical decision.

If a prescription appears in your inbox immediately after you click "submit," with no human in the loop, that's a structural failure. The issue isn't the exact number of minutes a clinician spends. The issue is whether a licensed clinician actually reviewed your intake and documented a plan.

What a good post-submission flow looks like:

  • A licensed clinician reviews your intake and follows up on any answer that triggered a flag — for example, prior pancreatitis, current insulin use, oral birth control with tirzepatide, or upcoming surgery.
  • You receive a treatment plan that names the medication, starting dose, escalation schedule, and what to do if you have side effects.
  • A licensed pharmacy fills the prescription. For compounded products, you should know the pharmacy by name.
  • You have a clear way to reach a clinician — not just a chatbot — with questions before, during, and after starting.
  • A first follow-up or check-in plan is stated before treatment begins, especially around dose escalation and side effects.

The Federation of State Medical Boards' telemedicine policy specifies that telemedicine care should arrange testing or referral when the standard of care requires it — that's another way of saying a real clinician is supposed to look at your case before you take medication.

What If You've Already Used a GLP-1 Before

If you have previously taken a GLP-1, the intake should ask which medication, your last dose, when you last took it, why you stopped, what side effects you experienced, and whether you used an FDA-approved or compounded product. Restarting at the wrong dose, especially after a gap, can sharply increase gastrointestinal side-effect risk because GLP-1 starting schedules are designed to begin low and escalate gradually.

A common pattern in 2026: a patient took a GLP-1 last year, stopped because of cost or insurance changes, and is now signing up with a new program. The new program asks them to "tell us anything we should know" and then prescribes them a maintenance dose without re-titrating. This is genuinely risky. A serious intake will ask:

Brand name and generic (Ozempic/semaglutide; Wegovy/semaglutide; Mounjaro/tirzepatide; Zepbound/tirzepatide; Saxenda/liraglutide; Rybelsus/oral semaglutide; or compounded versions)
Last dose taken
Date of your last injection or pill
Why you stopped (side effects, cost, insurance, supply, pregnancy, switching providers, lack of response)
Side effects you experienced and tolerated
Whether you missed doses regularly
Whether you used an FDA-approved or compounded version
If these questions weren't asked and you have prior GLP-1 history, do not start at a maintenance dose. Ask the provider in writing whether you should re-titrate from the lowest dose.

State Telehealth Rules That Affect Your Intake

GLP-1 receptor agonists are not federally controlled substances, but telehealth prescribing still depends on state licensure, the patient's location at the time of the visit, telehealth consent rules, pharmacy rules, and the clinician's standard-of-care judgment. Three things to verify:

1

Licensure. The clinician issuing your prescription must be licensed in the state where you are physically located when the visit happens. HHS Telehealth and the Federation of State Medical Boards both treat this as a baseline standard.

2

Informed consent. Some states require documented telehealth consent. A serious program collects it as part of intake.

3

Other obesity medications. GLP-1s themselves are not federally controlled. But if your provider also offers phentermine — a controlled substance with stricter telehealth rules in many states — different rules apply. Don't assume "telehealth" means the same thing for every weight-loss medication.

For current, state-by-state rules, the Center for Connected Health Policy maintains the most rigorously updated state telehealth policy database, and state medical boards publish their own rules directly. We don't reproduce state-by-state tables here because they change too often to be safely reproduced statically.

The Copy-Paste Script: Send This to Your Provider Before Your First Dose

Below is a single message you can copy, paste, and send to any GLP-1 telehealth provider. It asks for written confirmation of the items the FDA labels and 2025 professional society guidance say should be addressed before a first dose. A program operating at the standard of care will be able to answer it. A program that can't will reveal itself in how it answers.

Hi —

Before I take my first dose, I'd like to confirm a few things in writing.

  1. 1. Has a licensed clinician reviewed my intake, and is that clinician licensed in my state?
  2. 2. Did the screening cover the FDA contraindications listed on the Wegovy and Zepbound labels: personal or family history of medullary thyroid cancer or MEN2, and prior serious allergic reaction to the medication or its ingredients?
  3. 3. Did the screening cover the warning areas: pancreatitis, gallbladder disease, severe stomach disease or gastroparesis, kidney issues, diabetic retinopathy, mental health history, upcoming surgery or anesthesia, eating disorder history, and current pregnancy or planning?
  4. 4. Was a complete medication list collected, including insulin, sulfonylureas, oral birth control, and any narrow-therapeutic-index drugs?
  5. 5. Is the medication you are prescribing me FDA-approved or compounded? If compounded, what is the pharmacy name, and is it a 503A or 503B facility?
  6. 6. What is the starting dose and escalation schedule, and what should I do if I have side effects?
  7. 7. How can I reach a clinician — not a chatbot — for urgent questions, and what is your follow-up schedule?
  8. 8. What is the complete monthly cost, including refills and dose increases?

I'd like answers to all eight items in writing before I take my first dose. Thank you.

A program that responds with clear, specific answers in writing is operating at the standard of care. A program that pushes back, sends generic marketing copy, or charges you to ask the question has answered the question by how it answered it.

What If Your Intake Already Approved You and You're Worried

If you've already submitted an intake, been approved, and are now reading this with concerns, the safest path is to not take your first dose until you've sent the script above and gotten clear answers. You have three options:

1

Pause and verify. Send the script. Ask for written confirmation. If the program is solid, you've lost nothing but a day or two. If it isn't, you've avoided a real risk.

2

Push back specifically. Identify the exact items missing from your intake (use the 35-item checklist above). Ask the clinician to address each one before your first dose.

3

Switch programs. If the responses you get aren't reassuring, pause the prescription and find a program whose intake covers the full standard. Your money may or may not be refundable; that depends on the program's terms. Your safety isn't refundable.

Pausing long enough to verify the missing screening is a rational move. Send the script, ask for written answers, and don't take the first dose until the safety questions that apply to you have been answered.

If you're comparing provider programs before making a decision, see our best GLP-1 telehealth providers comparison — we note which programs have transparent intake flows and human clinician review.

How We Built This Standard (Methodology)

We assembled the 35-item checklist by reviewing current FDA prescribing information for every mainstream GLP-1 brand and cross-referencing recent FDA enforcement and safety actions, the 2025 joint advisory from OMA, ACLM, ASN, and The Obesity Society, the 2025 AACE algorithm for obesity treatment, the ADA's current Standards of Care, HHS Telehealth licensure and consent guidance, and Federation of State Medical Boards telemedicine policy.

What we actually verified

  • ·Wegovy prescribing information — Section 4 contraindications, Section 5 warnings and precautions, Section 7 drug interactions, Section 8 use in special populations, Section 17 patient counseling
  • ·Zepbound prescribing information — same sections, including the January 2026 oral contraceptive update
  • ·Ozempic, Mounjaro, Saxenda, Rybelsus prescribing information — current label contraindication and warning sections
  • ·FDA Drug Safety Communication, January 13, 2026, requesting removal of suicidal behavior and ideation warnings from Saxenda, Wegovy, and Zepbound
  • ·FDA press release, March 3, 2026, on warning letters to 30 telehealth firms over compounded GLP-1 marketing
  • ·FDA proposal of April 30, 2026 to exclude semaglutide, tirzepatide, and liraglutide from the 503B bulks list, with comments due June 29, 2026
  • ·2025 Joint Advisory from OMA, ACLM, ASN, and The Obesity Society on baseline screening and nutritional priorities for GLP-1 therapy
  • ·2025 AACE consensus algorithm for the evaluation and treatment of adults with obesity
  • ·American Diabetes Association Standards of Care, current annual update
  • ·HHS Telehealth program guidance on cross-state licensure and informed consent
  • ·Federation of State Medical Boards policy on the appropriate use of telemedicine
Items 8–21 — the FDA-label contraindication and warning items — map directly to specific Section 4 and Section 5 sections of the brand labels. Items 22–27 map to Section 7 drug interaction sections. Item 11 (pregnancy) maps to Section 8 special populations. Items 32 and 33 map to Section 17 patient counseling. Items 34 and 35, plus the scoring rubric, are operational quality criteria. The page is updated quarterly and any time an FDA label or major enforcement action changes.

Frequently Asked Questions

There's no published time standard for a GLP-1 telehealth intake. Time alone isn't the test — coverage is. An intake that approved you before it asked about medullary thyroid cancer, MEN2, your medications, and pregnancy did not cover the safety areas FDA labels flag, regardless of how long it took.

Yes — no current FDA prescribing label requires baseline lab work as a precondition for prescribing. The 2025 OMA joint advisory recommends careful baseline assessment as best practice, and the ADA recommends specific tests for patients with diabetes. The trade-off is that an intake without labs becomes the entire safety screen, so its rigor matters more.

The personal-and-family-history question about medullary thyroid cancer and MEN2. This is one of the few questions that appears as a Section 4 contraindication in every FDA label for every mainstream GLP-1 brand. A provider that doesn't ask it has skipped a Section 4 screening item.

The 2025 joint advisory from OMA, ACLM, ASN, and The Obesity Society lists mental health screening as part of baseline GLP-1 evaluation. In January 2026, the FDA requested removal of the suicidal behavior and ideation warning from Saxenda, Wegovy, and Zepbound after a comprehensive review found no increased risk. Mental health still belongs in a serious obesity-care intake — it affects treatment planning, support needs, and follow-up.

GLP-1 receptor agonists are not federally controlled substances, but telehealth prescribing still depends on state licensure rules, the state where you are physically located at the time of the visit, telehealth consent requirements, and pharmacy rules. The clinician must be licensed in the state where you are when the visit happens.

The safety screening shouldn't be weaker just because the product is compounded. But compounded products are not FDA-approved, and the FDA has stated that some compounded products use forms the agency considers different active ingredients, including semaglutide sodium and semaglutide acetate. That makes pharmacy identity, formulation, concentration, dosing instructions, and clear FDA-approved-vs-compounded disclosure even more important.

Send a written message listing the specific items that weren't screened (use the 35-item checklist or the copy-paste script on this page), and ask the provider to address each one before you take your first dose. If the response is unsatisfactory, don't start the medication. Either consult a primary care physician or switch to a program whose intake covers the full standard.

Almost always. A serious clinician review takes time. If you submit your intake and a prescription appears in your inbox before a clinician could possibly have read your answers, you've effectively been approved by a script, not a person. That's a structural shortcut.

503A pharmacies are state-licensed pharmacies that compound medications for individual patients with prescriptions, under state board of pharmacy oversight. 503B outsourcing facilities are FDA-registered and subject to FDA oversight and risk-based inspection. They're different legal categories. 503B registration alone is not a guarantee that a specific compounded GLP-1 product is lawful, safe, or equivalent to an FDA-approved drug.

Not quite. Both are listed separately as Section 4 contraindications on every mainstream GLP-1 label. They cover overlapping but not identical patient groups. The thoroughness of a program shows up in details like this — asking one but not both is a partial implementation, which often signals other items may be partial too.

Why We Built This

We built this checklist because the gap between a serious GLP-1 intake and a vending-machine intake is one of the clearest safety signals a patient can see before treatment starts. Patients shouldn't have to read FDA labels, professional society guidelines, telehealth policy pages, and FDA compounded-drug communications to know whether their intake was thorough enough. They should be able to read one page.

The GLP-1 telehealth space changed fast in 2025 and 2026. The FDA's 30 warning letters in March 2026 made one thing official: misleading compounded-GLP-1 marketing and obscured product sourcing are active enforcement targets. A 2025 Omada Health and Sermo survey of more than 2,000 primary care physicians found that two-thirds expressed concern about third-party telehealth GLP-1 prescribing and about continuity-of-care gaps.

FDA-approved GLP-1 medications can work for their approved indications. That doesn't make every online intake serious. Until the category matures, the rigor of your intake is one of the best visible signals you have for the rigor of the care you're about to receive.

This guide is educational and does not replace individualized medical advice. Always consult a licensed clinician about your specific situation. We do not use Reddit or forums as evidence for medical or regulatory claims; those come only from FDA prescribing labels, named professional society guidelines, and named regulatory sources. Last verified by WPG Research Team.