Programs & Add-Ons

Specialty Program Evaluation Request

Interested in Medical Weight Loss, Hormone Optimization, Peptide Therapy, or a combined program? Submit the request form below and our team will contact you with next steps.

Specialty programs require an evaluation before enrollment. Program approval is based on provider review, medical appropriateness, safety considerations, and whether the program is a good fit for your care needs.

Please do not include medical details, symptoms, diagnoses, medications, lab results, or urgent concerns in this form. This form is for appointment and program-interest requests only. If you are experiencing a medical emergency, call 911 or go to the nearest emergency department.

First and Last Name *

Phone Number *

Email Address *

Are you currently a member? *

What program are you interested in? *

Contact Preference

Best time to contact you

Morning

Afternoon

Either is fine

Our team will call or text you to review your request and confirm the next steps for scheduling. Active members may be contacted through Spruce secure messaging when appropriate. Please do not include medical details in this form.

A team member will contact you with next steps. If an evaluation is appropriate, the $99 Specialty Program Evaluation fee must be paid before the appointment is scheduled or confirmed.

* I understand that specialty programs require a one-time $99 Specialty Program Evaluation fee. I understand this fee must be paid before the evaluation appointment is scheduled or confirmed. I also understand that paying the fee and completing the evaluation does not guarantee acceptance into the requested program.