What is your legal name?

Enter it exactly as it appears on your government-issued ID.

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What is your email address?

We use this to connect your clinical review and payment.

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What is your mobile number?

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What is your date of birth?

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What sex were you assigned at birth?

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Are you pregnant, breastfeeding, trying to become pregnant, or planning pregnancy during treatment?

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Choose your PHYX plan

A one-time $20 consultation fee is added to your first checkout for the licensed clinician’s review. It does not recur with subscriptions.

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Confirm your telehealth consent

Type your full legal name below to confirm that the information you provided is complete and accurate, that you consent to a telehealth evaluation, and that you understand PHYX is a compounded oral capsule that is not FDA-approved. A licensed clinician will decide whether treatment is appropriate for you.

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What is the reason you are interested in this peptide?

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Have you ever used peptide therapies in the past?

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What peptides have you used previously?

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Have you ever had a reaction or side effects to peptide therapies in the past?

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What was your reaction or side effect?

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Do you currently have or have you been diagnosed with any of these medical conditions?

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Please confirm whether you have any history of cancer, kidney disease, or liver disease.

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Do you take any of these medications or substances?

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Do you have any known medication or ingredient allergies?

Select Yes and describe all known allergies for the clinician. The pharmacy will verify the final capsule ingredients before dispensing.

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Please list your allergies and describe any reactions.

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When was the last time you had an in-person medical evaluation?

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Confirm how you’ll take PHYX

PHYX is an oral capsule, not an injection. If prescribed, the directions are: “Take one capsule by mouth once daily.” Type your full legal name below to confirm that you understand these directions and will contact your clinician if you have questions.

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This is your first message to your doctor.

Introduce yourself and list any questions or concerns you would like the clinician to review.

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