Employer Medical Benefit
Complete this screening form to determine your eligibility. A licensed provider will review your information within 24-48 business hours.
You must be at least 18 years old to participate in this program. For questions, contact benefits@stratawell.com or call (719) 642-6389.
Patients over 75 may require additional medical review before starting GLP-1 therapy. You may continue your application and a provider will evaluate your eligibility. For questions, contact benefits@stratawell.com or call (719) 642-6389.
Are you currently pregnant? *
Are you currently breastfeeding? *
Are you planning to become pregnant? *
This program is not available for patients in this category at this time. For questions, contact benefits@stratawell.com or call (719) 642-6389.
Used to calculate BMI for clinical eligibility.
Your BMI
0
Your BMI may require additional provider review. You can continue your application.
Based on your BMI, you may not be eligible for this therapy at this time. You may continue your application. For questions, contact benefits@stratawell.com or call (719) 642-6389.
Which medication are you interested in? *
Are you currently taking a GLP-1 medication? *
Since you are already taking a GLP-1 medication, additional review may be required. You may continue your application. For questions, contact benefits@stratawell.com or call (719) 642-6389.
Have you taken metformin for at least 3 months? *
Do you have any of the following conditions? *
Based on your medical history, additional review may be required. You may continue your application. For questions, contact benefits@stratawell.com or call (719) 642-6389.
These questions help identify any contraindications for GLP-1 receptor agonist therapy.
Have you ever had an allergic reaction to any GLP-1 medication (e.g., semaglutide, tirzepatide, liraglutide)? *
A prior allergic reaction to a GLP-1 medication is a contraindication. Your application will be reviewed by a provider. For questions, contact benefits@stratawell.com or call (719) 642-6389.
Do you experience known episodes of hypoglycemia (low blood sugar)? *
If prescribed a GLP-1 medication, you should monitor your blood sugar regularly. Your provider will discuss this with you.
Help us understand your current habits and readiness for the program.
How often do you engage in physical activity or exercise? *
On a scale of 1-10, how ready do you feel to make changes to your health habits right now? *
5
Do you feel supported by family, friends, or your community in your health goals? *
What happens next:Your submission will be evaluated for eligibility within 24 to 48 business hours, after which you will receive a welcome email with further instructions.
GLP-1 Benefit Program
GLP-1 Benefit Program