Write a description of your survey here. Select any question below to change it. Then add questions as needed.

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* 1. Name

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* 2. Birthdate

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* 3. Sex

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* 4. Current weight and height

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* 5. Target weight

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* 6. Currently taking any GLP-1s

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* 7. Do you have a personal or family history of medullary thyroid cancer?

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* 8. Do you have a personal or family history of multiple endocrine neoplasia type 2 (MENS)

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* 9. Do you an allergy to GLP-1 agonists?

T