{"id":1148,"date":"2025-11-18T04:51:39","date_gmt":"2025-11-18T04:51:39","guid":{"rendered":"https:\/\/work.radditopro.com\/?page_id=1148"},"modified":"2025-12-07T08:51:24","modified_gmt":"2025-12-07T08:51:24","slug":"check-my-eligibility","status":"publish","type":"page","link":"https:\/\/preview.raddito.net\/trimtech-elementor\/check-my-eligibility\/","title":{"rendered":"Check My Eligibility"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-page\" data-elementor-id=\"1148\" class=\"elementor elementor-1148\">\n\t\t\t\t<div class=\"elementor-element elementor-element-205b1e7 e-flex e-con-boxed e-con e-parent\" data-id=\"205b1e7\" data-element_type=\"container\" data-e-type=\"container\" data-settings=\"{&quot;background_background&quot;:&quot;classic&quot;}\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-685c742 animated-slow elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"685c742\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInUp&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\">Start by completing a few quick questions.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e00e04c animated-slow elementor-widget__width-inherit elementor-invisible elementor-widget elementor-widget-jet-form-builder-form\" data-id=\"e00e04c\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeIn&quot;}\" data-widget_type=\"jet-form-builder-form.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<link rel='stylesheet' id='wp-block-library-css' href='https:\/\/preview.raddito.net\/trimtech-elementor\/wp-includes\/css\/dist\/block-library\/style.min.css?ver=6.9.4' media='all' \/>\n<style id=\"jet-form-builder-1116-inline-css\"><\/style><form  class=\"jet-form-builder layout-column submit-type-ajax\" action=\"https:\/\/preview.raddito.net\/trimtech-elementor\/wp-json\/wp\/v2\/pages\/1148\/?Qf8Q92=6q25Zlc3g29l&amp;method=reload\" method=\"POST\" data-form-id=\"1116\" data-layout=\"column\" enctype=\"multipart\/form-data\" novalidate=\"null\" ssr_validation_method=\"rest\"><input type=\"hidden\" id=\"_wpnonce\" name=\"_wpnonce\" value=\"753a395a81\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/trimtech-elementor\/wp-json\/wp\/v2\/pages\/1148\" \/>\r\n<input type=\"hidden\" name=\"_jfb_current_render_states[]\" value=\"DEFAULT.STATE\" data-jfb-sync \/><input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_booking_form_id\" data-field-name=\"_jet_engine_booking_form_id\" value=\"1116\">\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"_jet_engine_refer\" data-field-name=\"_jet_engine_refer\" value=\"https:\/\/preview.raddito.net\/trimtech-elementor\/wp-json\/wp\/v2\/pages\/1148\/\">\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"__queried_post_id\" data-field-name=\"__queried_post_id\" value=\"1148\">\n<div class=\"jet-form-builder-progress-pages jfb-progress-type--default jet-form-builder-progress-pages--global\" data-type=\"default\">\t<div class=\"jet-form-builder-progress-pages__item--wrapper active-page\" data-page=\"1\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">1<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Personal Details<\/div>\n\t\t<\/div>\n\t\t\t\t\t<div class=\"jet-form-builder-progress-pages__separator\"><\/div>\n\t\t\t<\/div>\n\t\t<div class=\"jet-form-builder-progress-pages__item--wrapper\" data-page=\"2\">\n\t\t<div class=\"jet-form-builder-progress-pages__item\">\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--circle\">2<\/div>\n\t\t\t<div class=\"jet-form-builder-progress-pages__item--label\">Last Page<\/div>\n\t\t<\/div>\n\t\t\t<\/div>\n\t<\/div><div class=\"jet-form-builder-page \" data-page=\"1\" data-page-offset=\"75\">\n<input type=\"hidden\" class=\"jet-form-builder__field hidden-field\" name=\"product_id\" data-field-name=\"product_id\" data-jfb-sync=\"null\">\n\n\n\n<div  class=\"jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field jet-fb-switch-page-on-change\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Are you over the age of 18? <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"q1\" value=\"1\" data-field-name=\"q1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Yes<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"q1\" value=\"0\" data-field-name=\"q1\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>No<\/span><\/label><\/div><\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field jet-fb-switch-page-on-change\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Do you have a family or personal history of medullary thyroid cancer?  <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"q2\" value=\"1\" data-field-name=\"q2\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Yes<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"q2\" value=\"0\" data-field-name=\"q2\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>No<\/span><\/label><\/div><\/div>\n<\/div>\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-c07ace36 wp-block-columns-is-layout-flex\" style=\"margin-top:0;margin-bottom:0;padding-top:0;padding-right:0;padding-bottom:0;padding-left:0\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-top:0;padding-bottom:0;flex-basis:100%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Weight (Lbs.) <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input placeholder=\"Ex. 140\" required=\"required\" name=\"weight\" id=\"weight\" type=\"text\" data-field-name=\"weight\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_mRkGXJPM\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-container-core-column-is-layout-b2a27621 wp-block-column-is-layout-flow\" style=\"padding-top:0;padding-right:0;padding-bottom:0;padding-left:0;flex-basis:100%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Height (Ft.) <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input placeholder=\"Ex. 5\" required=\"required\" name=\"height\" id=\"height\" type=\"text\" data-field-name=\"height\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_XrnoAfvb\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-container-core-column-is-layout-b2a27621 wp-block-column-is-layout-flow\" style=\"padding-top:0;padding-right:0;padding-bottom:0;padding-left:0;flex-basis:100%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Height (In.) <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input placeholder=\"Ex. 11\" required=\"required\" name=\"height_inches\" id=\"height_inches\" type=\"text\" data-field-name=\"height_inches\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_rR2cbMu6\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div  class=\"jet-form-builder-row field-type-calculated-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Your BMI<\/div><\/div><div data-formula=\"(%weight% \/ ((%height% * 12 + %height_inches%)**2)) * 703\" data-name=\"your_bmi\" data-precision=\"2\" data-sep-decimal=\".\" data-value-type=\"number\" data-date-format=\"YYYY-MM-DD\" class=\"jet-form-builder__calculated-field\">\n\t\t\t<input type=\"hidden\"\n\t\t\tname=\"your_bmi\"\n\t\t\tid=\"your_bmi\"\n\t\t\tvalue=\"\"\n\t\t\tclass=\"jet-form-builder__calculated-field-input jet-form-builder__field\"\n\t\t\tdata-field-name=\"your_bmi\"\n\t\t\tdata-jfb-sync\n\t\/>\n\t<div class=\"jet-form-builder__calculated-field-val\">0.00<\/div>\n\t\t<\/div>\n<\/div>\n\n\n<div  class=\"jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field jet-fb-switch-page-on-change\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Are you currently taking a GLP medication? <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"q4\" value=\"1\" data-field-name=\"q4\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Yes<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"q4\" value=\"0\" data-field-name=\"q4\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>No<\/span><\/label><\/div><\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-radio-field wp-block-jet-forms-radio-field\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\"> If Female, are you currently pregnant or breastfeeding? <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__fields-group checkradio-wrap\" data-jfb-sync><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"q5\" value=\"1\" data-field-name=\"q5\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>Yes<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"q5\" value=\"0\" data-field-name=\"q5\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>No<\/span><\/label><\/div><div class=\"jet-form-builder__field-wrap radio-wrap checkradio-wrap\"><label class=\"jet-form-builder__field-label for-radio\">\n<input type=\"radio\" name=\"q5\" value=\"0\" data-field-name=\"q5\"  class=\"jet-form-builder__field radio-field checkradio-field\" required=\"required\"><span>N\/A<\/span><\/label><\/div><\/div>\n<\/div>\n\n<div class=\"jet-form-builder__next-page-wrap\">\n\t\t\t\t\t<button class=\"jet-form-builder__next-page\" type=\"button\">Next<\/button>\n\t<\/div>\n<\/div>\n<div class=\"jet-form-builder-page jet-form-builder-page--hidden\" data-page=\"2\" data-page-offset=\"75\">\n\n<div class=\"jet-form-builder__conditional \" data-jfb-conditional=\"[{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;0&quot;,&quot;field&quot;:&quot;q1&quot;,&quot;use_preset&quot;:false},{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;1&quot;,&quot;field&quot;:&quot;q2&quot;,&quot;use_preset&quot;:false},{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;0&quot;,&quot;field&quot;:&quot;q4&quot;,&quot;use_preset&quot;:false},{&quot;operator&quot;:&quot;less&quot;,&quot;value&quot;:&quot;27&quot;,&quot;field&quot;:&quot;your_bmi&quot;,&quot;use_preset&quot;:false},{&quot;__visible&quot;:false,&quot;or_operator&quot;:true},{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;1&quot;,&quot;field&quot;:&quot;q5&quot;,&quot;use_preset&quot;:false},{&quot;__visible&quot;:false,&quot;or_operator&quot;:true},{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;1&quot;,&quot;field&quot;:&quot;q2&quot;,&quot;use_preset&quot;:false}]\" data-jfb-func=\"{&quot;show&quot;:{&quot;dom&quot;:true}}\">\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\"><\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<h1 class=\"wp-block-heading has-text-align-center\">Thank You for Your Interest!<\/h1>\n\n\n\n<p class=\"has-text-align-center\">Based on the information you provided, it looks like you may not currently meet the medical requirements for Semaglutide or Tirzepatide treatment. Your health and safety come first, and these guidelines help ensure that every patient receives appropriate and safe care.<\/p>\n\n\n\n<div class=\"wp-block-separator has-text-color has-alpha-channel-opacity has-background is-style-wide\" style=\"margin-top:20px;margin-bottom:30px;background-color:#1a1a1a42;color:#1a1a1a42\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Why You May Not Qualify:<\/h2>\n\n\n\n<p>One or more of the following factors may apply:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>You are under 18 years of age.<\/li>\n\n\n\n<li>You have a personal or family history of medullary thyroid cancer or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).<\/li>\n\n\n\n<li>Your Body Mass Index (BMI) does not meet the required eligibility range.<\/li>\n\n\n\n<li>You are currently pregnant or breastfeeding.<\/li>\n\n\n\n<li>You are taking another GLP-1 medication, and your BMI does not meet the threshold for safe concurrent treatment.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What You Can Do Next<\/h2>\n\n\n\n<p>We encourage you to speak with a licensed healthcare provider who can guide you through alternative weight-management options.<br>A clinician can evaluate your unique needs and help determine whether you may be eligible for GLP-1 treatment in the future or if a different solution would be a better fit for your goals.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Your Safety Is Our Priority<\/h2>\n\n\n\n<p>Your well-being matters deeply to us.<br>If you have questions, want clarification, or need help understanding your next steps, our support team is always here for you. Please feel free to reach out anytime.<\/p>\n\n\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-fill\"><a class=\"wp-block-button__link has-white-color has-text-color has-background has-link-color has-custom-font-size wp-element-button\" href=\"\/\" style=\"border-style:none;border-width:0px;border-radius:30px;background-color:#5d0e09;padding-top:16px;padding-right:24px;padding-bottom:16px;padding-left:24px;font-size:16px;line-height:1\">Back To Home<\/a><\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<\/div>\n\n<div class=\"jet-form-builder__conditional \" data-jfb-conditional=\"[{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;1&quot;,&quot;field&quot;:&quot;q1&quot;,&quot;use_preset&quot;:false},{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;0&quot;,&quot;field&quot;:&quot;q2&quot;,&quot;use_preset&quot;:false},{&quot;operator&quot;:&quot;greater&quot;,&quot;value&quot;:&quot;19&quot;,&quot;field&quot;:&quot;your_bmi&quot;,&quot;use_preset&quot;:false},{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;1&quot;,&quot;field&quot;:&quot;q4&quot;,&quot;use_preset&quot;:false},{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;0&quot;,&quot;field&quot;:&quot;q5&quot;,&quot;use_preset&quot;:false},{&quot;__visible&quot;:false,&quot;or_operator&quot;:true},{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;0&quot;,&quot;field&quot;:&quot;q4&quot;,&quot;use_preset&quot;:false},{&quot;operator&quot;:&quot;greater&quot;,&quot;value&quot;:&quot;27&quot;,&quot;field&quot;:&quot;your_bmi&quot;,&quot;use_preset&quot;:false},{&quot;operator&quot;:&quot;equal&quot;,&quot;value&quot;:&quot;0&quot;,&quot;field&quot;:&quot;q2&quot;,&quot;use_preset&quot;:false}]\" data-jfb-func=\"show\">\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:100%\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:100%\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-c07ace36 wp-block-columns-is-layout-flex\" style=\"margin-top:0;margin-bottom:0;padding-top:0;padding-right:0;padding-bottom:0;padding-left:0\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-top:0;padding-bottom:0;flex-basis:100%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">First Name <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"first_name\" id=\"first_name\" type=\"text\" data-field-name=\"first_name\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_Bna2y5YT\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-container-core-column-is-layout-b2a27621 wp-block-column-is-layout-flow\" style=\"padding-top:0;padding-right:0;padding-bottom:0;padding-left:0;flex-basis:100%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Last Name <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"last_name\" id=\"last_name\" type=\"text\" data-field-name=\"last_name\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_CwldcSEb\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-c07ace36 wp-block-columns-is-layout-flex\" style=\"margin-top:0;margin-bottom:0;padding-top:0;padding-right:0;padding-bottom:0;padding-left:0\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"padding-top:0;padding-bottom:0;flex-basis:100%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Email <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"email\" id=\"email\" type=\"text\" data-field-name=\"email\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_jqcY4e6J\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-container-core-column-is-layout-b2a27621 wp-block-column-is-layout-flow\" style=\"padding-top:0;padding-right:0;padding-bottom:0;padding-left:0;flex-basis:100%\"><div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Phone <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"phone\" id=\"phone\" type=\"text\" data-field-name=\"phone\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_4FwqCvhA\">\n\t\t\t\t\t<\/div>\n<\/div><\/div>\n<\/div>\n\n\n<div  class=\"jet-form-builder-row field-type-text-field\" >\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Address <span class=\"jet-form-builder__required\">*<\/span><\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t\t\t\t<input required=\"required\" name=\"address\" id=\"address\" type=\"text\" data-field-name=\"address\" class=\"jet-form-builder__field text-field\" data-jfb-sync=\"null\" autocomplete=\"off_udzYBP1y\">\n\t\t\t\t\t<\/div>\n<\/div>\n\n<div  class=\"jet-form-builder-row field-type-select-field wp-block-jet-forms-select-field\">\n<div class=\"jet-form-builder__label\">\r\n<div class=\"jet-form-builder__label-text\">Choose the Program That Fits<\/div><\/div><div class=\"jet-form-builder__field-wrap\">\n\t<select class=\"jet-form-builder__field select-field\" name=\"choose_the_program_that_fits\" data-field-name=\"choose_the_program_that_fits\" id=\"choose_the_program_that_fits\" data-jfb-sync=\"null\">\n\t\t<option value=\"p1\" >Tirzepatide (GIP\/GLP-1)<\/option><option value=\"p2\" >Liraglutide ( GLP-1)<\/option><option value=\"p3\" >Metabolic-B Complex<\/option><option value=\"p4\" >Semaglutide (GLP-1)<\/option>\t<\/select>\n<\/div>\n<\/div>\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-28f84493 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-submit-field\" >\n\t<div data-type=\"submit\" class=\"jet-form-builder__action-button-wrapper jet-form-builder__submit-wrap\">\n\t<button class=\"jet-form-builder__action-button jet-form-builder__submit submit-type-ajax\" type=\"submit\">Proceedto Checkout<\/button>\n\t<\/div>\n\t\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><div  class=\"jet-form-builder-row field-type-submit-field\" >\n\t<div data-type=\"prev\" class=\"jet-form-builder__action-button-wrapper\">\n\t<button class=\"jet-form-builder__action-button jet-form-builder__prev-page\" type=\"button\">Previous<\/button>\n\t<\/div>\n\t\n<\/div><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n<\/div><\/div>\t<div class=\"jet-form-builder-messages-wrap\" data-form-id=\"1116\"><\/div>\n<\/form>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Start by completing a few quick questions. 1 Personal Details 2 Last Page Are you over the age of 18? * Yes No Do you have a family or personal history of medullary thyroid cancer? * Yes No Weight (Lbs.) * Height (Ft.) * Height (In.) * Your BMI 0.00 Are you currently taking a 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