Health Assessment

Nice to meet you !

Blue Sky MD has been helping thousands of patients find success with their health outcomes since 2008, so we know a thing or two about losing weight and optimizing hormones the right way.

Our age influences our metabolism and hormonal health. What is your date of birth?*
MM slash DD slash YYYY

Sex also plays a key role in hormones and metabolism. Which one best describes you?*
- MALE
- FEMALE
- DECLINE TO ANSWER

Our ability to lose weight is up to 80% determined by genetics.

An individualized approach to weight loss can help us work with what we have.

The average Blue Sky MD member loses about 10% of their body weight after 3 months on the program.*

Losing as little as 5% can reduce your risk of developing health problems like type II diabetes and heart disease.

The next set of questions will help us determine if you may be suffering from a hormone imbalance.

Are you currently experiencing menopause or hot flashes? If so, for how long?*
- A FEW WEEKS
- 6-12 MONTHS
- MORE THAN A YEAR
- NO
Are you currently experiencing erectile dysfunction? If so, for how long?*
- A FEW WEEKS
- 6-12 MONTHS
- MORE THAN A YEAR
- NO

Have you recently experienced a sudden decrease in physical strength or muscle mass?*
- YES
- NO
- NOT SURE

Unlike other weight loss programs, Blue Sky MD isn't one-size-fits-all.

We like to craft your plan using by understanding underlying issues like hormones, behaviors, and emotional health.

Weight needs to be approached from a healthcare perspective...

The next set of questions will help us determine if prescription GLP-1 weight loss medication could help you overcome some common barriers to weight loss.

What is your current weight in pounds?*
This helps us calculate your BMI. This will help us to determine your care path, so it’s important to be as accurate as possible.

Thanks! Based on your results, you are a good fit for our medical weight loss program.

You may also qualify for FDA-approved GLP-1 weight loss medications.

These medications work on the reward center of your brain to curb cravings for certain foods. In combination with diet and exercise, Semaglutide helps our patients stick to a reduced-calorie diet and enhance the weight loss process.
Thanks! Based on your results, you are a good fit for our combined medical weight loss and hormone therapy program.
Thanks! Based on your results, you are a good fit for our hormone therapy program.

Your next step is to schedule an initial appointment to explore medical history, discuss goals, and meet with a provider.
A patient care coordinator can help you get started and answer any questions. May we contact you to help you schedule your first appointment?*
- Yes, text me.
- Yes, call me.
- No, thanks!
We are a HIPAA compliant company and we do not share your data—but we would like to send you the occasional email! By selecting a "yes" option you are agreeing to receive communications from Blue Sky MD.

We offer both in-person office visits and flexible virtual appointments. Which Blue Sky MD location are you nearest to?*

For most patients, we're able to bill insurance. However, we also offer affordable self-pay options. Which do you prefer?*
No worries! Thanks for exploring your options with Blue Sky. We're always here to help answer questions as you do more research.

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