From intake
to first vial, in under a week.
Four steps. No video calls unless your prescriber requests one. The clinical work happens asynchronously, the pharmacy work happens in parallel — that's how a 503A telehealth service is designed to work.
Tell us your story.
A 6-minute medical questionnaire — goals, history, current medications, optional lab uploads. No video required, ever.
A clinician reads it.
A US-licensed prescriber reviews within 48 hours, asks follow-ups if needed, and writes a prescription only when the protocol fits.
The pharmacy ships.
Cold-shipped from a 503A pharmacy with a self-administration kit, dosing schedule, and a one-page primer.
We check in.
A wellness pulse from your prescriber every 90 days. Adjust, swap, or pause from your dashboard. No subscription handcuffs.
The intake.
The intake form takes most patients about six minutes. It is the most important six minutes of the relationship — your prescriber reads everything you write.
You'll cover: legal name, date of birth, state of residence, height and weight, activity level, medical history (with explicit screening for thyroid history, pancreatitis, eating disorders, and the conditions that exclude specific protocols), current medications and supplements, allergies, and a free-text section for whatever didn't fit.
What happens with your information.
Encrypted at rest and in transit. Visible only to the prescriber assigned to your case and the pharmacy that fills the prescription. Pepra is HIPAA-compliant; we are not in the business of selling patient data and we never will be.
If you decide not to proceed after submitting the intake, we delete the record on request — and automatically after 12 months of inactivity.
The review.
Your intake is queued to a US-licensed clinician who is licensed in your state. Within 48 hours, the clinician reads it top to bottom and decides one of three things:
Issue the prescription. The protocol fits, no follow-up needed. The pharmacy is notified.
Message you with follow-ups. Something needs clarifying, lab work would help, or the prescriber wants to suggest a different compound. You'll see a secure message in your dashboard.
Decline the protocol. Sometimes the answer is "this isn't right for you." You won't be charged. The clinician writes a brief note explaining why, often with an alternative — sometimes including "see a specialist who can examine you in person."
The prescriber network.
Pepra clinicians are MDs, NPs, and PAs licensed in the state where they prescribe. They are independent clinicians — Pepra contracts with them; we don't direct their clinical decisions. That's intentional. The platform is the rails; the clinical judgment is theirs.
The dispense.
Once a prescription is issued, it's transmitted to one of our 503A compounding pharmacy partners. Section 503A of the Federal Food, Drug, and Cosmetic Act is the legal pathway that allows licensed pharmacies to compound medications for an individual patient under a valid prescription.
Our pharmacy partners are USP-797 compliant for sterile preparations and PCAB-accredited. They are licensed in your state of residence to ship there. We list our partners by state in your dashboard.
What arrives.
A cold-shipped insulated package, requiring an adult signature, typically arriving in 5–7 business days. Inside:
· The vial(s) of compounded peptide, lyophilized
· Bacteriostatic water for reconstitution
· Insulin syringes (sized to your dose)
· Alcohol pads
· A pre-paid sharps return mailer
· A one-page dosing primer
· A clinical references packet
Refrigerate the vials immediately on receipt. The reconstitution and first-dose primer is short and clear; most patients say their first injection is the only nervous one.
Monitoring.
This is where many telehealth services stop paying attention. Pepra is built around the opposite assumption — that the work after the prescription is what determines whether the protocol actually helps.
Monthly secure check-ins.
For every active protocol, you'll get a 3-question wellness pulse from your prescriber once a month — tolerability, perceived effect, anything you want to flag. It takes 90 seconds. The prescriber reads every reply.
Quarterly clinical reviews.
Every 90 days, your prescriber does a more substantive review — looking at adherence, lab refreshes if relevant, and whether to adjust, swap, or step down. This is when most protocol changes happen.
Pause and resume from your dashboard.
You can pause a protocol any time before your next refill ship. The pharmacy is notified; the next shipment is held. To resume, your prescriber re-reviews any updates and the protocol restarts. We never auto-renew without an explicit clinical re-review.
Six minutes. One prescriber.
Start your intake. If a protocol fits, your first vial cold-ships within a week. If not, you'll hear that — and won't be charged.