Beluga Portal

Essence Brown

Female · 8/16/1979 (45y) · TX menuDots

Phone: 8176554941

All Visits (7)

Weightlossfollowup

Master Id: 93f1f25b-5b18-4b7e-bffe-b5ab3e2e00f2

Active

Current Visit

Created on: 2-20-2025

Updated on: 2-22-2025

Weightlossfollowup

Master Id: eed5703a-6ec3-41f5-bce4-1559e025fbc6

Resolved

Go to this visit

Created on: 11-2-2024

Updated on: 11-4-2024

Resolved on: 11-4-2024 (Prescribed)

Weightloss

Master Id: f37604c8-c2b7-4f3f-96ed-32912e82ea11

Resolved

Go to this visit

Created on: 9-25-2024

Updated on: 11-3-2024

Resolved on: 9-26-2024 (Prescribed)

Weightlossfollowup

Master Id: 45e6fe00-b303-47d6-9959-fd5fb8182653

Resolved

Go to this visit

Created on: 8-15-2024

Updated on: 8-15-2024

Resolved on: 8-15-2024 (Prescribed)

Weightlossfollowup

Master Id: a6300098-b823-445e-a40e-c7ea9fdb696b

Resolved

Go to this visit

Created on: 7-2-2024

Updated on: 7-2-2024

Resolved on: 7-2-2024 (Prescribed)

Weightloss

Master Id: 87ef74c7-2311-4ebe-98d8-1c80afcb5351

Resolved

Go to this visit

Created on: 6-5-2024

Updated on: 6-6-2024

Resolved on: 6-6-2024 (Prescribed)

baskAmbleHealth Weightlossfollowup

Active Visit

Master Id: 93f1f25b-5b18-4b7e-bffe-b5ab3e2e00f2

Consents for telemedicine and privacy policy signed?	true
First Name	Essence
Last Name	Brown
Date of Birth	08/16/1979
Phone Number	8176554941
Email	255457+792857@bask.health
Address	806 South Atkerson Lane
City	Euless
State	TX
Zip	76040
Sex	Female
Patient preference	Name: Revive Amble Tirzepatide 10 mg strength: 10mg refills: 0 quantity: 4 Injections MedId: VIVE-300096391-TB6
Self-reported Meds	None
Allergies	No
Medical Conditions	No
Current Weightloss Med	semaglutide
Current Dose	Weightloss5
Weightloss Change	increase
BMI	"Height: 5'4 Weight: 163lbs BMI: 27.98"
Are you currently, or have you in the past two months, taken any of the following medications? Semaglutide (Ozempic, Wegovy, Rybelsus) Tirzepatide (Zepbound, Mounjaro) None of these	Semaglutide (Ozempic, Wegovy, Rybelsus)
What dose are you currently taking? Month 1 (0.25mg) Month 2 (0.5mg) Month 3 (1.0mg) Month 4 (1.75mg) Month 5 (2.5mg) Other / Not Sure	Month 4 (1.75mg)
Please select from the following options Stay at the same dose or equivalent dose Increase dose Decrease dose	Increase dose
Do you have your current medication available? Yes No	Yes
Have you experienced side effects from your current medication? Yes No	No
Do you have any of the following current and past medical conditions? No, I don't have any of the below conditions Inflammatory bowel disease Pancreatitis Pancreatic cancer Gallbladder disease Hypertriglyceridemia (elevated triglycerides) Kidney injury or kidney disease Insulin-dependent diabetes Thyroid cancer Family history of thyroid cancer Family history of MEN-2 syndrome PCOS with fertility problems Eating disorder, past or present Suicidal thoughts in the past 12 months Anorexia or bulemia Gastroparesis	No, I don't have any of the below conditions
General Guidelines The traditional use of weight loss medications is for individuals with a BMI of 30 and above or to those who are overweight who have associated health conditions. Using it for someone in your BMI range (27-29) without an accompanying health condition is termed "off-label." Using a medication "off-label" refers to the practice of prescribing a drug for a purpose, age group, dosage, or form of administration that is not included in the approved labeling by regulatory agencies like the U.S. Food and Drug Administration (FDA). While a medication undergoes rigorous testing for specific uses before receiving approval, healthcare providers may discover through clinical experience or research that it can be effective for treating other conditions. There may be benefits such as weight reduction for individuals within your range. If you agree to this off-label use, it's crucial to follow the prescribed regimen and report any concerns. Please discuss any questions with us.	I consent
Have you had a gastric bypass in the past 6 months? Yes No	No
Are you allergic to any of the following? Ozempic (Semaglutide) Wegovy (Semaglutide) Zepbound (Tirzepatide) Mounjaro (Tirzepatide) Saxenda (Liraglutide) None of the above	None of the above
Do you take any of the following medications? Yes No	No
Are you currently pregnant or planning to become pregnant soon? Yes No	No
Are you currently breastfeeding? Yes No	No
Pregnancy and Breastfeeding precaution The FDA says that these medications may pose a risk to the developing fetus (baby) if you get pregnant while taking it “The pill” (oral contraception) is not enough because this medication can interfere with the effectiveness. For birth control you must use condoms, an IUD, or the implant. Official FDA recommendations: For the first month after first starting a weight loss medication, and for the first month after each dose escalation, continue using your oral contraception and add a barrier method of contraception (such as condoms) to prevent pregnancy. Alternatively, you can switch to a non-oral contraceptive method (such as an IUD or implant) before starting your medication. When you stop the medication, you must continue using a backup method (like condoms) for two months after stopping to allow the medication to fully leave your system before getting pregnant. Similarly, it is not known to be safe in breastfeeding. If you are breastfeeding, consult your doctor for safe weight loss options	I consent
Truthfulness consent Consent: I have reviewed, understand, and attest that the information I have provided above is true to the best of my knowledge. I understand that it is critical to my health to share complete health information with my doctor. I will not hold the doctor or affiliated medical practice responsible for any oversights or omissions, whether intentional or not in the information that I provided above.	I consent
Do you have any thing else to ask or tell your doctor? Yes No	No
Fulfillment I understand typical pharmacy fulfillment ranges from 7-10 business days, but may arrive sooner. ---------- Returns I understand if prescribed, this medication will be made specifically for me and such prescription medication is not eligible for return. ---------- Cancellations I understand that upon a script (eRX) being issued and sent to a partner pharmacy, my order cannot be changed. Amble will make every effort possible to cancel the order with the pharmacy but make no implied guarantee. In the event the order can be cancelled, a $100 nonrefundable visit and clinical fee will be withheld from your refund. ---------- Customer Information I understand that I am responsible for filling out this questionnaire accurately and my answers will be used by my medical provider in determining medical appropriate treatment. ---------- Order Processing I understand that proceeding and enrolling will constitute an order being processed. ---------- Treatment I acknowledge that there are risks of side effects or other outside medical events, such as potential pregnancy. However, these risks do not absolve financial responsibility for the medication, even if discontinuation is necessary before the treatment course is completed. There is no implied guarantee with medication and it is nonrefundable. ---------- Disclaimer Amble Health prescribes medications like Ozempic, Wegovy, or Zepbound, These are among the most effective weight loss medications on the market. Membership includes a provider consultation and prescription (if appropriate), access to GLP-1 medication, and the ongoing care and support you need to keep the weight off. † Ozempic®, WeGovy®, Saxenda®, and Victoza® are registered trademarks of Novo Nordisk. Zepbound® and Mounjaro® are registered trademarks of Eli Lilly. Amble Health is not affiliated with Novo Nordisk or Eli Lilly, and the compounded products offered by Amble are not produced by these companies. Compounded medications may be prescribed when appropriate based on patient medical need. While federal law allows the prescription of compounded drugs, they are not FDA-approved and do not undergo safety, effectiveness, or manufacturing review.	I consent
Shortage is now resolved The FDA has marked Tirzepatide as no longer in shortage. This means that we must provide you the commercially available medication unless there is a medical necessity for a personalized compounded treatment plan. ---------- Price Variability Your prescriber will determine what medication is right for you. Your dose and form will be determined by your prescriber after checkout. The product shown on the checkout page is not necessarily the medication you will be prescribed.	I consent
Have you been prescribed this medication previously? Yes No	No
Have you tried to obtain brand name Zepbound or Mounjaro? Yes No	Yes
Shortage is now resolved The FDA has marked Tirzepatide as no longer in shortage. This means that we must provide you the commercially available medication unless there is a medical necessity for a personalized compounded treatment plan. ---------- Compounding ---------- Ineligbility for Compounded Medication ---------- Eligbility for Compounded Medication	I consent

Medicine Selection

Pharmacy:Revive Rx

Search Medication

Deselect All

Revive Amble Tirzepatide 5mg

Revive Amble Tirzepatide 7.5 mg

Revive Amble Tirzepatide 10 mg

Revive Amble Tirzepatide 12.5 mg

Revive Amble Tirzepatide 15 mg

Revive Tirzepatide 2.5 mg

Assessment & Plan (Internal Note)

Patient has been educated on the treatment plan including instructions for use, risks/benefits/side effects.
                    No contraindications, red flags, or dangerous polypharmacy interactions identified.
                    If any side effects occur they should discontinue use and contact me for further instruction, except in the case of severe side effects in which case they should seek urgent care in an emergency room.
                    FOLLOW UP: The patient has been provided information on how to contact our medical team to follow up if any medical concerns or reactions to treatment arise at any time.
                    The patient is recommended to follow up with myself or the support team if additional concerns arise or the treatment plan needs to be adjusted.
                    Patient has been educated that there are limitations to telemedicine care, and in-person care may be necessary in certain situations (ER if severe side effects develop or through an in-person physician if signs/symptoms develop that warrant additional work up/evaluation/alternative treatments).
                    To the extent that I have been made aware by the company with which I contract to provide medical services,
                    the patient has signed relevant attestations prior to being assigned to me as a clinician that state that the patient is aware of any limitations in a virtual health encounter and understands that urgent or emergent care must be pursued in person.
                    I have confirmed the patient's identity via review of a legally recognized form of ID or through a second party identity verification service.
                    Please see doctor/patient messaging thread for any relevant dialogue which, in addition to providing supplemental medical information as needed, secures and meets the legally-defined doctor-patient relationship.
                    Telemedicine is appropriate for this patient encounter because it can meet the same standard of care for this patient's chief complaint and can improve access to care which remains limited in many parts of the United States.