Weight Loss Made Personal

A few quick questions so your clinician can confirm the right plan for you.

Licensed Clinicians

HSA/FSA Approved

No Hidden Fees

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First name

Last name

Date of birth

Phone

State (2-letter)

Plan of interest

Compounded Semaglutide — $179 first month, then $299/moCompounded Tirzepatide — $350 first month, then $399/moNot sure yet — I'd like clinician guidance

Height (inches)

Current weight (lbs)

Goal weight (lbs)

Screening questions:

Pregnant or breastfeedingHistory of pancreatitisPersonal or family history of medullary thyroid carcinoma or MEN 2History of gallbladder disease

Diabetes status

Current medications (comma-separated)

Known allergies (comma-separated)

I consent to a telehealth evaluation by a licensed Afuri clinician.I consent to treatment with a compounded medication (compounded semaglutide or tirzepatide) as part of this program.I understand this is not an emergency service and does not create a clinician-patient relationship until my intake is reviewed and accepted.I'm also interested in the Facial Club membership bundle.

This intake does not create a clinician-patient relationship. A licensed Afuri clinician will review your information and determine if treatment is appropriate.

Where Your Beauty Is Our Purpose.

@afuriaesthetics

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6365 W. Sample Rd
Coral Springs, FL 33067
(728) 206-2340
info@afuriaesthetics.com
Mon: 10am–6pm
Sat: 10am–3pm
Appointment Only

All treatments require consultation. Results vary. This website is for informational purposes only and does not replace medical advice. Afuri Aesthetics & Wellness proudly serves Sunrise, Weston, Plantation, Coral Springs, Davie, Fort Lauderdale, and surrounding South Florida communities.

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