Quick Eligibility Check

Let's make sure we're the right fit.

Before completing your full intake, please answer 5 quick questions. Takes about 60 seconds. Your answers help us ensure PeptideVIP can safely provide care for you.

Question 1
Have you been diagnosed with cancer, or are you currently undergoing cancer treatment?
Please select an answer to continue.
Question 2
Are you currently pregnant, breastfeeding, or planning to become pregnant in the next 3 months?
Please select an answer to continue.
Question 3
Have you had an organ transplant and are currently taking immunosuppressant medications?
Please select an answer to continue.
Question 4
Are you under 18 years of age?
Please select an answer to continue.
Question 5
Do you have any of the following? (select all that apply)

Don't worry — selecting any of these doesn't automatically disqualify you. Your provider will review your history carefully.

Great news — you're a candidate for care.

Based on your answers, PeptideVIP can provide physician-prescribed peptide therapy for you. Your responses have been noted and will help your provider personalize your protocol.

Continue to Intake Form →

The full intake form takes about 5 minutes and captures your medical history.

We appreciate you reaching out.

Based on your answers, PeptideVIP may not be the right fit for peptide therapy at this time. This is to ensure your safety and that you receive the most appropriate care for your situation.

Return to PeptideVIP

Questions? Text us at (305) 930-6467 and we'll do our best to help.