GLP-1 Clinic Patient Intake Forms: First Impressions Matter in a Premium Market

Why Does Your GLP-1 Clinic's Intake Experience Matter So Much?

Quick answer: GLP-1 weight loss is a premium, cash-pay service—patients are spending $300-500+ per month out of pocket. The first thing they experience isn't your clinical expertise or your bedside manner. It's your intake form. If that form is a clunky PDF that doesn't work on mobile, you've undercut your premium positioning before the patient ever walks through your door.

This isn't hyperbole. Patient reviews of GLP-1 clinics consistently highlight intake experience as a key differentiator. The clinics that succeed are described as "concierge-style" with intake that feels "quick and straightforward." The ones that struggle get reviews mentioning "computer glitches," "double charges," and "multiple steps before treatment begins."

The Math of First Impressions

Consider what your patient is thinking when they land on your intake form:

  • They've already decided to spend significant money on weight loss
  • They're comparing you to telehealth giants like Hims, Ro, and Amazon One Medical
  • They're probably filling out your form on their phone (70%+ of patients do)
  • They're judging whether your clinic is "legitimate" and "professional"

Now imagine they tap your intake link and get a PDF that requires pinch-zooming to read, doesn't save their progress, and asks them to print/sign/scan a consent form. Does that feel like a premium $400/month service? Or does it feel like a clinic that's still figuring things out?

Your intake form is your first clinical touchpoint. Make it count.

What Forms Do GLP-1 Weight Loss Clinics Actually Need?

Quick answer: At minimum, GLP-1 clinics need a comprehensive health history questionnaire, BMI/eligibility screening, detailed informed consent covering serious risks (thyroid cancer, pancreatitis, gastroparesis), contraindication screening, and treatment agreements. If you're using compounded medications, you need additional disclosures. If you see Medicare patients, you need ABN forms.

1. Medical History & Eligibility Screening

This is your clinical foundation. You need to capture:

  • Current weight, height, and BMI calculation
  • Weight loss history and previous attempts
  • Current medications (especially insulin, sulfonylureas, other diabetes medications)
  • Comorbidities relevant to eligibility (hypertension, dyslipidemia, pre-diabetes, sleep apnea)
  • Contraindication screening (personal/family history of medullary thyroid carcinoma, MEN2 syndrome, pancreatitis, severe GI disease, pregnancy/breastfeeding)

Per FDA-approved labeling, GLP-1 medications for weight management are typically prescribed for adults with BMI ≥30 or BMI ≥27 with at least one weight-related condition. Your intake should automatically flag patients who don't meet criteria.

2. GLP-1-Specific Informed Consent

This isn't a generic consent form. GLP-1 medications carry specific risks that require explicit acknowledgment:

  • Thyroid C-cell tumor risk — Patients must acknowledge they understand the boxed warning about thyroid tumors in rodent studies
  • Pancreatitis risk — Signs to watch for, when to stop medication and seek care
  • Gastrointestinal effects — Nausea, vomiting, diarrhea, constipation, gastroparesis
  • Hypoglycemia risk — Especially when combined with insulin or sulfonylureas
  • Injection site reactions — For injectable formulations
  • No guarantee of results — Weight loss varies; this is not a magic solution

3. Compounded Medication Disclosure (If Applicable)

If you're prescribing compounded semaglutide or tirzepatide, you need additional consent that explicitly states:

  • Compounded medications are NOT FDA-approved
  • The medication is being prepared by a 503A or 503B pharmacy based on individual patient need
  • Risks specific to compounded formulations
  • Patient acknowledgment that they understand the difference between brand-name and compounded versions

This isn't optional. It's both a legal requirement and protection for your practice.

4. Treatment Agreement

Beyond informed consent, you need a treatment agreement covering:

  • Payment terms and refund policies
  • Follow-up visit requirements
  • Patient responsibilities (reporting side effects, attending appointments, following dosing instructions)
  • Conditions for treatment discontinuation
  • What happens if patient becomes pregnant

Do GLP-1 Clinics Need Medicare ABN Forms in 2026?

Quick answer: Yes—for now. Medicare currently does not cover GLP-1 medications for weight loss (federal law prohibits it). However, CMS announced the BALANCE model launching in mid-2026, which will begin covering these medications for eligible beneficiaries. Until then, any Medicare patient needs an ABN explaining they're responsible for the full cost.

The 2026 Medicare Landscape

Here's what's happening:

Current state: Medicare Part D cannot cover drugs prescribed for weight loss. This is a statutory prohibition, not just a coverage decision.

Coming soon: CMS launched the BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) Model. A Medicare GLP-1 payment demonstration begins July 2026 as a bridge, with the full model launching in Medicare Part D in January 2027.

What this means for your clinic: For the first half of 2026, every Medicare patient needs an Advance Beneficiary Notice of Noncoverage (ABN) explaining that Medicare will not pay for their GLP-1 medication when prescribed for weight loss.

ABN Requirements for GLP-1 Clinics

Your ABN must include:

  • Clear identification of the service/medication that may not be covered
  • The reason Medicare may not pay (prescribed for weight loss, which is a non-covered indication)
  • Estimated cost the patient will be responsible for
  • Patient signature acknowledging they understand and accept financial responsibility

Important: Even after BALANCE launches, you'll likely still need ABNs for patients who don't meet the program's eligibility criteria. Phase 1 covers patients with BMI >27 plus prediabetes or cardiovascular disease. Phase 2 expands to BMI >30 plus hypertension, kidney disease, or heart failure. Patients outside these criteria will still be paying cash.

EasyDocForms includes Medicare ABN support with automatic eligibility flagging—so you know which patients need an ABN before you start treatment.

What Should Your GLP-1 Clinic Terms and Conditions Cover?

Quick answer: Your terms and conditions need to cover payment policies (especially for cash-pay patients), refund and cancellation terms, medication shipping and handling, telehealth consent (if applicable), HIPAA authorization, and what happens when patients don't follow the protocol. Make these readable and signable on mobile.

Essential Terms for GLP-1 Clinics

1. Payment and Billing Terms

GLP-1 clinics are overwhelmingly cash-pay. Your terms should clearly state:

  • Total cost including consultation fees, medication, and any included services
  • Payment schedule (monthly subscription vs. per-visit)
  • What's included vs. what costs extra (labs, additional consultations, dose adjustments)
  • Accepted payment methods

2. Refund and Cancellation Policy

This is where disputes happen. Be explicit:

  • Under what circumstances (if any) are refunds available
  • What happens if patient discontinues treatment early
  • Medication that has shipped cannot be returned (controlled substance regulations)
  • Subscription cancellation process and timing

3. Medication-Specific Terms

  • Medication is prescribed based on clinical evaluation and may be discontinued if not appropriate
  • Patient must complete required follow-up appointments to continue receiving prescriptions
  • Dosing changes require provider consultation
  • Medications cannot be shared with others

4. Telehealth Consent (If Applicable)

  • Acknowledgment that telehealth has limitations
  • Emergency protocols (what to do if patient has a serious reaction)
  • Technology requirements
  • State-specific prescribing limitations

How Do Patient Intake Systems Compare for GLP-1 Clinics?

Quick answer: Most intake solutions either lack healthcare-specific features (generic form builders), charge per-provider fees that don't scale (IntakeQ), or require extensive DIY setup (JotForm). EasyDocForms offers $49/month flat pricing with white-glove setup—send us your existing forms and we build the digital versions for you.

Feature EasyDocForms IntakeQ JotForm Google Forms
Monthly Price$49 flat$49.90+ per provider$99 (HIPAA tier)"Free" (risky)
HIPAA CompliantYes (BAA included)YesOnly Gold tierManual config
GLP-1 Consent TemplatesYesBuild yourselfBuild yourselfNo
Medicare ABN SupportYesLimitedNoNo
Mobile Completion70%+VariesVariesPoor
White-Glove SetupYesNo (DIY)No (DIY)No
Conditional LogicYesYesYesLimited
E-SignaturesESIGN/UETA compliantYesYesNo

Why White-Glove Setup Matters for GLP-1 Clinics

You're running a medical practice, not a form-building business. DIY drag-and-drop builders mean hours spent recreating your consent forms, risk of missing required disclosures, and ongoing maintenance when requirements change.

With EasyDocForms, you send us your current PDF consent forms—or just describe what you need—and we build everything. GLP-1 informed consent, contraindication screening, Medicare ABN, treatment agreements, all mobile-optimized and ready to deploy.

Key Takeaways

  • GLP-1 is a premium service—your intake should match that premium positioning
  • Required forms: medical history, GLP-1-specific informed consent, compounded medication disclosure (if applicable), treatment agreement
  • Medicare ABN required until BALANCE model launches in July 2026
  • Make consent readable: plain-language summaries, conditional logic, mobile optimization
  • 70%+ of patients complete intake on mobile—design for that reality
  • EasyDocForms: $49/month flat, white-glove setup, GLP-1-specific templates included

Frequently Asked Questions

What informed consent is required for GLP-1 medications?

GLP-1 informed consent must cover the FDA boxed warning about thyroid C-cell tumors, contraindications (medullary thyroid carcinoma, MEN2 syndrome, pancreatitis history), common side effects (nausea, vomiting, diarrhea, constipation), serious risks (pancreatitis, gastroparesis, hypoglycemia), and injection technique if applicable. If prescribing compounded medications, additional disclosures about non-FDA-approved status are required.

Does Medicare cover GLP-1 medications for weight loss in 2026?

Not yet, but coverage is coming. Medicare currently cannot cover drugs prescribed for weight loss due to statutory prohibition. However, CMS launched the BALANCE model with a demonstration program starting July 2026 and full Medicare Part D coverage beginning January 2027. Until then, Medicare patients need an ABN (Advance Beneficiary Notice) explaining they're responsible for the full cost.

What's the difference between brand-name and compounded GLP-1 medications?

Brand-name GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound) are FDA-approved with established safety and efficacy data. Compounded versions are prepared by 503A or 503B pharmacies based on individual patient need and are NOT FDA-approved. Clinics prescribing compounded medications must obtain separate informed consent acknowledging this distinction and the associated risks.

How long should GLP-1 clinic intake take patients to complete?

Aim for 5-10 minutes total. Successful GLP-1 clinics report patient satisfaction is highest when intake feels "quick and straightforward." Use conditional logic to show only relevant questions, allow progress saving for patients who need to pause, and optimize for mobile completion.

Do GLP-1 clinics need HIPAA-compliant intake forms?

Yes. GLP-1 clinics collect protected health information (PHI) including medical history, current medications, weight data, and treatment records. Your intake system must be HIPAA compliant with a signed Business Associate Agreement (BAA), encryption for data in transit and at rest, access logging, and proper authorization for any data sharing with pharmacies or other providers.

Can patients sign GLP-1 consent forms electronically?

Yes. Electronic signatures are legally valid under the ESIGN Act and UETA for medical consent forms, including GLP-1 informed consent. Your e-signature system should capture timestamp, IP address, and clear evidence of intent to sign. EasyDocForms provides ESIGN/UETA-compliant electronic signatures that work seamlessly on mobile devices.