The Cellular Woman
Client Intake — GHL Connected
Before We Begin
Please read carefully. This must be acknowledged before continuing.
Educational Consultation — Not Medical Advice
The Cellular Woman is an educational wellness resource, not a medical practice. Cori Zigman is not a licensed physician, nurse practitioner, pharmacist, or any other licensed healthcare professional.
Nothing in this intake process, any follow-up consultation, or any written material from The Cellular Woman constitutes medical advice, diagnosis, or treatment of any kind.
By completing this form, you acknowledge:
- All information is for educational purposes only to support informed conversations with your licensed physician.
- Peptides are research compounds. Use requires supervision by a licensed prescribing physician.
- You are solely responsible for consulting your own physician before beginning any supplement, peptide, or wellness protocol.
- The Cellular Woman assumes no liability for any health outcome, adverse event, or decision made based on information from this service.
- This screening exists to identify whether physician clearance is needed before any educational consultation proceeds.
- Physician referrals issued through this screening are requirements, not suggestions.
- If you are pregnant, breastfeeding, under 18, or under active physician care for a serious condition, you must obtain physician clearance before any consultation.
Tell Us About You
Health Screening
This determines whether physician clearance is required before any consultation. Be thorough — this protects you.
Physician Clearance Required
One or more conditions you’ve selected require physician evaluation before any consultation with The Cellular Woman can proceed. Please speak with your doctor first.
Conditions Noted — Physician Discussion Advised
Some of your responses may require a conversation with your physician before starting certain protocols. These will be flagged in your summary.
Select all that currently apply.
(Warfarin, Eliquis, Xarelto, Plavix, Aspirin daily, etc.)
Tell Us What’s Going On
This is the most important section. The more specific you are, the better the educational output.
What Are You Working Toward?
Select all that apply. Combinations are used to weight your protocol output.
Intake Complete
Educational consultation summary. Not a prescription or medical recommendation.
Share this summary with your physician when discussing whether peptide protocols may be appropriate for you. A follow-up educational consultation can be scheduled after physician clearance has been obtained where indicated.