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Hormone Therapy
Weight Management
Emsculpt
Immune Health
Primary Care

Hormone Therapy
Weight Management
Emsculpt
Immune Health
Primary Care

Semaglutide Quiz

Free screening for our Semaglutide Weight Management Program (and if you are a candidate for insurance coverage)

Are you a candidate for Semaglutide or Tirzepatide?

"*" indicates required fields

Step 1 of 11

9%

Company

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Name*

Phone*

Email*

1. Have you tried and failed other weight loss programs in the past?*

Yes

No

2. Do you struggle with carbohydrate cravings?*

Yes

No

3. Do you feel hungry most of the time?*

Yes

No

4. Do you have a history of type 2 diabetes?*

Yes

No

5. Do you have a history of high cholesterol?*

Yes

No

6. Do you gain weight around your abdomen?*

Yes

No

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Score

7. Do you have a history of kidney problems?*

Yes

No

8. Do you have a history of pancreatitis?*

Yes

No

9. Do you have a history of suicide or suicidal thoughts?*

Yes

No

10. Do you have a personal or family history of thyroid cancer?*

Yes

No

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non-candidate-Score

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non-candidate

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non-candidate: Kidney problems

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non-candidate: Pancreatitis Hx

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non-candidate: Mental health

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non-candidate: Thyroid Cancer

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3-5

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6-10

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11-14

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Harmony in Health seeks to earn your trust by providing high-quality, honest, personalized medical care. Our priority is to focus on the needs of our patients by actively allowing them to restore their overall Health.

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Location

10680 Main St., Suite 130
Fairfax, VA 22030
Phone: 703.544.9113
info@harmonyinhealth.net

(Located on 1st Floor Suite 130 of Mainland Building)

Hours of Operation

Monday: 10:00 AM–1:00 PM
(Virtual Only)
Tuesday: 9:00 AM–12:30 PM | 2:30 PM–7:00 PM
Wednesday: 9:00 AM–12:30 PM | 2:30 PM–7:00 PM
Thursday: 9:00 AM–12:30 PM | 2:30 PM–7:00 PM
Friday: 9:00 AM–1:00 PM
(Admin Only)
Saturday: 10:00 AM–4:00 PM (Emsculpt only)
Sunday: CLOSED

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Annandale VA | Fairfax VA | Fairfax Station VA | Oakton VA | Vienna VA

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