Weight Loss Intake form
Fill out the entry form below to create your profile with Beauty Rx Aesthetics.
You will be sent a medical history form and consents for review and electronic signatures.
After the medical team reviews your forms and eligibility, our healthcare providers will reach out to schedule a virtual or in-person consultation to review dosage recommendations within the purchased plan, required supplies for administration, and answer any questions before sending your order to the pharmacy. Please note that we will need a photo of your drivers license to submit the order to the pharmacy.
The pharmacy will process the order and will ship the medication to your home.
We are available via text or call whenever you have any questions during your treatment.
If you have any issues or questions: Please email elina@beautyrxaesthetics.com