Your monthly check-in

Tell us how your journey is going — it takes about a minute.

⚠️ This isn’t for emergencies. If something is urgent or you’re having a medical emergency, call 911 or contact your provider right away.

About you Email

Use the email on your Peak Wellness account.

First name

Last name

Phone (optional)

Your progress

Starting weight (lb)

Current weight (lb)

Your daily energy needs

We use this to estimate the calories your body burns, so we can help you eat the right amount while losing weight.

Height (ft)

Height (in)

Age

Sex assigned at birth (used only for the calorie formula)

Female Male

Activity level

How it’s going How are side effects treating you?

None Mild, manageable Bothering me a lot Severe

How is your progress going overall?

Going great Okay Stuck / no change

If it were up to you, would you want your dose to…

Your doctor makes the final call — this just helps guide the conversation.

Go up Stay the same Go down

Any new surgeries, medications, or medical conditions since your last check-in? (leave blank if none) Anything you’d like help with? (optional)

Lifestyle check How’s your mood been lately?

😞1 😞2 😕3 😕4 😐5 😐6 🙂7 🙂8 😄9 😄10

How often are you exercising? How are your eating habits? How’s your sleep? Energy compared to before you started?

Quick feedback How satisfied are you with your progress?

1 2 3 4 5 6 7 8 9 10

How satisfied are you with Peak?

1 2 3 4 5 6 7 8 9 10

What could make it better? (optional)

Website

Thanks, ! ✅

Weight change so far

Your estimated BMR (calories burned at rest)

Your estimated daily burn (with activity)

📬 We review every check-in within 24–48 hours and will reach out if anything needs attention. Want to talk to someone sooner or need help? Email support@trypeak.com.