Medically supervised weight management Report

Refill Request for Established Patients Only

  • You must be an established patient to complete an online refill request.
  • Submit requests at least 3-5 days prior to running out of medication
  • Requests will only be approved if you are no more than 5 days early
  • Allow 48 hours for refills to be processed
  • Refills requested on Saturday or Sunday will be processed the following business day.

Financial Agreement

I agree to pay in full for all services rendered after completing this progress report. There will not be any refund if medication is left at the pharmacy for longer than 7 days. There will not be a refund for lost or stolen medication. There will not be a refund if the pharmacy denies the prescription due to no fault of Get Well Clinic. There will not be a refund if you change your mind about continuing the program.

paper with weight loss plan

Medically Supervised Program 1

weights and tape measure

Medically Supervised Program 2

syringe with a red fluid

Lipo-C/ B12 Injection Bundle (must pick up in office)

vials and syringe

Hcg Program 23 Day (syringes) (must pick up in office)

doctor with a stethoscope on the smartphone screen

Telemedicine Visit


Call 832-781-4340 before making payment

    Your Cart
    Your cart is emptyReturn to Shop