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Patient Resources

Request Form 
(Mail Form)

At Holland Clinic, we offer a convenient Patient Request for Telemedical Services Form for Medical Weight Loss. This form can be used to request telemedical care, which is also referred to as a "mail visit". If you are no more than one month late, please use this form to request telemedical care. However, if you are a patient who is more than 1 year late, please use our "New and Former Patient" form. We look forward to providing you with the best quality of care.

New & Former

Program Start

Vector art of a runner at the starting line

For Classic & GLP-1 Both

Our Medical Weight Loss program offers public access to start forms to get the process of losing weight started. These forms are available to totally new as well as patients whose last visit was more than one year ago. Please note that these forms are not for active current patients. The process of completing the forms should take between 30-45 minutes and people should have their medical histories and prescription information ready in order to assist with form completion.

Request Letter(s)

Letters Requests

Patients may request a letter from us for if they are an active and current. These letters may include a letter of medical necessity, urine toxicology explanation, an excuse from work absence, or any other type of letter. Turnaround time is usually less than one day.

Access Program


At our medical weight loss practice, we provide our active patients with access to teaching materials that are normally given to them at their first visit. These materials include helpful information about diet, exercise, and weight loss medications. Patients may access the forms online or download them in .pdf format for their convenience. Our weight loss program documents are designed to provide our patients with the resources necessary to make informed decisions regarding their health and weight loss goals.

Order Body Math


Body Math

Introducing our new line of Body Math brand over-the-counter supplements! Our ultra high quality custom line of supplements uses only the purest ingredients, sourced exclusively from the United States. We guarantee that none of our ingredients are sourced from foreign countries, so you can trust the quality and safety of our products. Our Body Math supplements are specifically designed to help you reach your medical weight loss goals.

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