Contact Us for a Personalized Plan

Since none of us are exactly the same there is not a one size fits all approach to weight management. Other factors must be considered before starting any weight management program. Let me customize a program just for you. 

If you would like a personalized plan or if you would like to talk to Pharmacist Keith directly, complete the following survey and we will get in touch with you.

First Name Last Name

Address

City State Zip

Phone Email

Current Situation

What is the main health challenge you would like to solve?

How important is your health (scale 1 to 10)?

Where would you rate your health right now (scale 1 to 10)?

What diets have you tried in the past?

Goals

What is your goal weight?

How serious are you about reaching your goal weight (scale 1 to 10)?

How quickly would you like to achieve your goal weight?