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Dana · Wellness Intake

Tell me about your
wellness journey

A few questions to help us understand where you are and where you want to go

A note from Dana Lerma, NP

Hey! I am Dana. Nurse Practitioner and wellness advocate. After years of not feeling like myself I finally found what worked. Fill out the form below and I will send you a personalized wellness education report based on your situation and goals. You are not alone in this.

Question 01

What are your top health concerns right now?

Select everything that feels true for you. There are no wrong answers.

Question 02

Tell us a little about yourself

This helps Dana tailor the education she sends to your specific situation.

Question 03

Help Dana understand your health background

This helps ensure the education report is relevant to your specific situation. Your EllieMD physician will conduct a full medical review before prescribing anything.

Do you have any of the following conditions?

Are you currently taking any prescription medications?

You do not need to list every medication. Focus on daily medications that may interact with wellness compounds.

Have you had any significant surgeries in the last 5 years?

Any known allergies to medications or supplements? Optional

Question 04

What have you already tried?

No judgment here. Knowing what you have already done helps Dana understand where to start.

Have you used GLP-1 or peptide compounds before?

Question 05

What does success look like for you in 90 days?

Paint a picture. How do you want to feel? What do you want to be able to do?

Question 06

Your personalized wellness education report will be sent to your email. Social handles are optional. Many of Dana's clients prefer to connect where they feel most comfortable.

Your personalized wellness education report will be sent to this email
Optional, only if you prefer to be reached by text
Something went wrong. Please try again, or reach out to Dana directly.

Your information is kept private and used solely to deliver your wellness education report. It is never sold or shared with third parties. Privacy Policy

Dana Lerma is an Independent EllieMD Brand Partner. Lerma Longevity is not an EllieMD corporate website.

Your report is on its way.

Thank you for sharing your wellness journey. Your personalized wellness education report will arrive in your email shortly. Dana will reach out personally within 24 to 48 hours to answer any questions you have.