Select all that apply — we'll tailor your screening and recommend the best peptides.
Weight Loss
Appetite Control
Low Energy
Brain Fog
Low Testosterone
Low Libido
Skin & Anti-Aging
Hair Thinning
Joint Pain
Gut Issues
Injury Recovery
Muscle Loss
Tell us about yourself
This information helps us personalize your recommendations.
I understand that my information is never shared, is protected by HIPAA and I agree to receive communications by text message and phone calls regarding appointments and product related messages and calls from Mars by GHC and its medical partners, and agree to the terms and privacy policies and can opt-out at anytime by replying STOP or ask for more information by replying HELP. Message frequency varies. Message and data rates may apply.
Weight Loss Screening
Help us find the safest and most effective weight loss plan for you.
With medication, you could lose 3 to 4 pounds per week.
It will take about — weeks to reach your goal weight of — lbs.
—Current
—Goal
—Lbs to Lose
—BMI
How is that pace for you?
Works for me
Want it faster
Too fast
Have you taken medication for weight loss within the past 4 weeks?
Yes, I've taken GLP-1 medication
Yes, a different weight loss medication
No
Have you tried a weight management program (Jenny Craig, Weight Watchers, etc)?
Yes
No
What is your blood pressure range?
<120/80 (Normal)
120 to 129/<80 (Elevated)
130 to 139/80-89 (High Stage 1)
≥140/90 (High Stage 2)
Which is most important to you?
Affordability (Lowest price)
Potency (Stronger dose)
GLP-1 is available as an injection or a dissolvable tablet. Which sounds best?
I prefer to inject (One injection per week)
I prefer a tablet (One tablet per day)
Energy & Cognitive Screening
Let's understand your energy and focus levels to find the best solution.
How long have you been experiencing low energy or brain fog?
Less than 1 month
1 – 6 months
6 – 12 months
More than a year
How would you rate your current energy level?
Very low — I struggle to get through the day
Low — I often feel drained
Moderate — it comes and goes
Fluctuating — high crashes followed by fatigue
How is your sleep quality?
Poor — I rarely feel rested
Fair — some good nights, some bad
Good — I usually sleep well
Which best describes your primary goal?
More sustained daily energy
Sharper mental focus and clarity
Both energy and focus
Hormonal Health Screening
Help us understand your symptoms to recommend the right therapy.
How long have you been experiencing these symptoms?
Less than 3 months
3 – 12 months
More than a year
Have you had your hormone levels tested?
Yes — levels were low
Yes — levels were normal
No, I haven't been tested
Which symptoms apply to you?
Low sex drive
Erectile difficulty
Chronic fatigue
Mood changes
Reduced muscle mass
Unexplained weight gain
Are you currently on any hormone therapy?
Yes
No
Skin & Hair Screening
Let's find the best peptide for your skin and hair goals.
What is your primary concern?
Wrinkles & fine lines
Skin elasticity & firmness
Hair thinning
Noticeable hair loss
Skin repair & scarring
Overall anti-aging
How long have you noticed these changes?
Less than 6 months
6 – 12 months
1 – 3 years
More than 3 years
Are you currently using any skin or hair treatments?
Yes, prescription treatments
Yes, over-the-counter products
No
Recovery & Healing Screening
Tell us about your pain or recovery needs.
Which best describes your concern?
Chronic joint pain
Acute injury (tendon, ligament, muscle)
Gut or digestive issues
Post-surgery recovery
How long have you been dealing with this?
Less than 1 month
1 – 6 months
6 – 12 months
More than a year
How would you rate the severity?
Mild — noticeable but manageable
Moderate — it limits some activities
Severe — it significantly impacts daily life
Are you currently receiving any treatment for this?
Yes
No
Muscle & Performance Screening
Help us find the right peptide for your fitness goals.
How often do you currently exercise?
Rarely
1 – 2 times per week
3 – 4 times per week
5+ times per week
How long have you noticed muscle loss?
Recently (1 – 3 months)
Several months
More than a year
What is your primary goal?
Build new muscle
Maintain current muscle mass
Recover lost muscle
Medical history
Select any conditions that apply so our physicians can review your profile.
Hypertension
Diabetes (Type 1 or 2)
Heart condition
Kidney or liver disease
Thyroid condition
Cancer (current or past)
GI condition (IBD, reflux)
Mental health condition
Autoimmune disorder
Medication allergy
None of the above
Do you have any further information for our medical team?
Yes
No
Your Medical Review
Review your information and check your eligibility.
Summary
BMI
—
Current Weight
—
Goal Weight
—
Concerns
—
Your information is never shared and is protected by HIPAA.
Your Peptide Plan
You have a very high chance of success with peptide therapy — 95%
