This form is ONLY intended for patients enrolling in:

Dr. Camille Jones Johnson’s Weight Management Program.

Registration will be reviewed and this account will be activated upon verification of eligibility, granting the following benefits:

  • FREE personal onboarding call
  • FREE Shipping on all orders!
  • Discounts on ALL Product Purchases
  • Points & Rewards Loyalty Program
  • Extended Program Services
    • Exclusive Weight Management Program Content
    • Virtual Access to Program and Product Support

Weight Management Program

Enrollment Form and Treatment Plan

Profile Information

required to create a private account
please choose your unique username

Treatment Plan Details

Please record the treatment plan details in this section.
Meal Replacement - Restricted Carb plans ( < 75g carb) will lose on average up to 5 lbs per week, while Partial Meal Replacement plans will lose on average 2 to 3 lbs per week
Total daily caloric intake (in calories)
Meal Replacement - Restricted Carb plans (500-750 cal)
Partial Meal Replacement - hypocaloric plans (1000-1500 cal)
Total number of betterMD meal replacements per day
Approximately 1/2 cup cooked or 1 cup raw, 5g Carb, 25 calories per serving
Break larger goals into bite-sized chunks—set daily and weekly targets
These provide motivation and should include more than just weight goals
General notes regarding this specific treatment plan
Relevant medical information: comorbidities, medication changes, and any specific recommendations
My primary care provider will continue to manage my health care, and betterMD will provide guidance and support for the use of its medically engineered nutrition products for weight control.
 
*All patients should consult with a healthcare provider prior to starting a weight loss program.