Extended Hold: Mild SE, plateau → hold current dose for 4 more weeks
Split Dosing: GI intolerance → divide weekly dose into 2 injections
Micro-Titration: Severe SE, can't tolerate next step → increase by half-step
Plateau Escalation: No weight loss 6+ weeks at current dose → advance
Dose Reduction: Persistent AE → drop back one step
System Rules
Estrogen Formulary
Progesterone Formulary
Triage → Rx Gate Mapping
Triage
Rx Status
Visit
Action
🟢 GREEN
ACTIVE
Not required
Continue — next refill auto-scheduled
🟡 YELLOW
ACTIVE
Async review
Continue — physician reviews within 24–72h
🟡 YELLOW×2
ACTIVE (soft flag)
Recommended
Continue — recommend $75 tele-visit
🔴 RED
PAUSED
REQUIRED
Hold Rx — $75 tele-visit before resume
Missed Check-In Downgrade
0–6 days since last check-in → no change
7–13 days → downgrade one tier (GREEN→YELLOW; YELLOW→YELLOW; RED→RED)
≥ 14 days → hard downgrade to RED, Rx paused, check-in required to unblock
Patient-Facing Legal Language
"Prescription continuation is based on ongoing clinical assessment through patient monitoring. Additional evaluation may be required when clinically indicated."
❌ Never use: "auto refill guaranteed", "no visit needed ever", "automatic prescription"
Medical Services (via Stripe)
Initial Visit
$200
Initial Lab Panel
$125
Telemedicine Visit (PRN)
$75
6-Month Reassessment (optional)
$200
Payment methods: Credit Card, Apple Pay, Google Pay, Afterpay, Klarna (BNPL via Stripe).
⚠ INTERNAL ONLY — Tirzepatide Cost/Margin (never patient-facing)
Dose
Cost
Patient
Margin
Medications fulfilled through partner pharmacies (DPR manual, Olympia API pending). Never billed through Stripe.
Patient Phases
Initial Visit ($200) — intake, history, consent, Rx plan
Goal Achieved → Maintenance — transition to maintenance protocol
Programs
Manage patient enrollment by program
GLP-1 / Metabolic — 31 Active Patients
Tirzepatide protocols. Includes metabolic reset, adjunct Rx, nutrition planning.
JD
Jane Doe
Wk 8 · Tirzepatide 7.5mg · 187 lbs
LR
Lisa Rodriguez
Wk 4 · Tirzepatide 2.5mg · 203 lbs
Women's Health / BHRT — 18 Active Patients
Bioidentical hormone therapy. DUTCH testing, thyroid optimization, bone health.
SM
Sarah Miller
Mo 3 · Estradiol + Progesterone
AP
Ana Perez
Mo 1 · New patient
Both Programs — Patients on GLP-1 + BHRT
Patients enrolled in both metabolic and hormone optimization programs.
KW
Karen Williams
Mo 6 · GLP-1 + BHRT
RenuviaMD® Monthly Custom Meal Plan
Preview the weekly plan a patient receives — calculated from their nutrition profile.
Patient
Program
Sex
Age
Height (cm)
Weight (kg)
Activity
Diet
Nutritional Information Disclaimer
The RenuviaMD® Monthly Custom Meal Plan is provided for educational and informational purposes only and is not a substitute for individualized medical or nutritional advice. Calorie counts, macronutrient values, and portion sizes shown are estimates based on standard nutritional references and may vary depending on ingredient brands, preparation methods, and serving sizes.
This meal plan is a suggested framework to support the patient’s treatment program. It is not a prescription. Patients should adjust portions based on hunger, satiety, and physician guidance.
Before recommending significant dietary changes — particularly for patients with food allergies, chronic conditions, or medications with known food interactions — review ingredient labels against the patient’s personal allergen list.
Daily Calories
—
Protein
—
Carbs / Fat
—
Fluids
—
Week Preview
Click Generate to build a preview.
Grocery List
—
Physical Activity Program
Generate a safe, tolerance-adjusted 7-day exercise plan for a patient. Red-flag gate enforced.
Exercise Plan Disclaimer
This exercise plan is general guidance based on your record and does not replace medical advice. Exercise within your tolerance, especially if using GLP-1 therapy. Stop and contact your clinician if you develop concerning symptoms such as chest pain, dizziness, severe breathlessness, vomiting, or inability to hydrate.
Patient Profile
Program
Sex
Age
Walking tolerance (min)
Activity level
Experience
Days / week
Session (min)
Location
Exercise Clearance (check any that apply in the last 7 days)
Medical Limitations
Tier
—
Days / wk
—
Session
—
Target RPE
—
Week Preview
Click Generate to build a preview.
Cautions & Notes
—
Billing & Revenue
Invoicing, payments, and practice revenue
MTD Revenue
$19.8K
96.5% collection
Outstanding
$683
2 invoices
Est. ARR
$214K
at 47 patients
Capacity ARR
$438K
at 125 patients
Payment Processors
PAY
Credit Card + BNPL
Visa / MC / Amex · Apple Pay · Google Pay · Afterpay · Klarna
Connected
Revenue by Program
GLP-1 (31 pts)$77.5K
BHRT (18 pts)$63.0K
Add-On Revenue$12.5K
Collect Visit Payment
Send this payment link to the patient:
Click to copy.
Recent Invoices
Jane Doe — Initial Visit
Jan 13, 2026 · Credit Card
$200Paid
Sarah Miller — Tele-Visit
Dec 15, 2025 · Credit Card
$75Paid
Karen Williams — Initial Visit
Oct 1, 2025 · Credit Card
$200Paid
Messages
Patient communications
JD
Jane Doe
Question about dose timing · 2h ago
Unread
SM
Sarah Miller
Side effects concern · Yesterday
Unread
LR
Lisa Rodriguez
Thank you for the nutrition plan · Mar 8
Read
AI Assistant
Claude-powered clinical tools — all drafts require physician review
AI AI generates drafts only. All clinical content must be reviewed and signed by the physician before use.
SOAP
SOAP Note
Generate from visit data
LAB
Lab Interpretation
Analyze results + flags
FU
Follow-Up Report
Progress summary
MSG
Patient Message
Draft communication
POT
Plan of Treatment
POT document
SUM
Patient Summary
Complete overview
SOAP Note
Practice Analytics
Live metrics from Supabase
Active Patients
--
Total active
GLP-1 / Metabolic
--
$399/mo program
BHRT / Hormonal
--
$199/mo program
Both Programs
--
GLP-1 + BHRT
Est. Monthly Revenue
--
Based on active patients
Total Medication Orders
--
All time
Total COGs
--
Medication cost
Check-In Compliance
--
Last 100 check-ins
Patient Distribution
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Intake Pipeline
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Select a patient to begin
Program · Visit Type
1
Payment
Not started
Collect $200 Initial Visit fee before starting clinical discussion.
$200 Credit Card
2
Chief Complaint
Not started
GLP-1
BHRT
Both
3
Confirm Intake
Not started
Review pre-filled intake answers. Correct any errors.
Yes
No (Hysterectomy)
< 1 month
1-12 months
12+ months
4
Physical Exam / General Appearance
Not started
5
Symptom Deep Dive (BHRT)
Not started
Occasional
Daily
Multiple/day
Constant
Mild
Moderate
Severe
None
Mild
Moderate
Severe
None
Mild
Moderate
Severe
6
Patient Preferences (BHRT)
Not started
Yes
No
Topical
Oral
No Preference
Yes
No
7
GLP-1 Assessment (GLP-1)
Not started
Tirzepatide
Slow (8 wk/step)
Standard (4 wk/step)
Micro (+1mg/2wk)
2.5 mg — Initiation (Step 1)
None
Mild nausea history
Significant GI history
8
Lab Review
Not started
Walk patient through abnormal values. Add clinical notes per flag.