Every comparison site has a checklist. Most are five vague bullet points reworded from the same FDA consumer guidance page. Ours is not that.
This is the 20-point vetting standard we built from fourteen months of platform audits, FDA enforcement tracking, pharmacy board actions, and the July 2026 Yale secret shopper study. It's what we actually use to score platforms on our Watchlist. We're publishing it because the only way the market gets better is if patients can audit providers the same way we do.
How the scoring works
Each of the 20 points is binary: the platform either meets it or doesn't. No partial credit. Some points are weighted — the five marked with ★ are critical, meaning a failure on any one of them drops the platform below our recommendation threshold regardless of the overall score.
A platform scoring 16+ with no critical failures earns a Watchlist recommendation. 12-15 is "conditional" — usable with eyes open. Below 12, or any critical failure, is "not recommended."
Section A: Licensing and legal structure (5 points)
1. ★ Prescribing clinicians are identifiable by name and NPI. You should be able to find your prescriber's full name and National Provider Identifier before or immediately after your consultation. Platforms that attribute prescriptions to "our medical team" without individual identification fail this point. Run any NPI through the CMS NPI Registry to confirm it's real, active, and matches the claimed specialty.
2. Clinicians hold active licenses in the patient's state. Under telehealth prescribing law, the prescriber must be licensed in the state where the patient is located — not where the prescriber sits. We verify this using each state's medical board license lookup. Platforms that can't confirm their prescribers' state coverage fail.
3. The platform discloses its corporate structure. Is it a medical practice? An MSO managing a separate medical practice? A technology marketplace? This matters because it determines who is legally responsible if something goes wrong. Platforms that don't disclose this anywhere on their site — not even in their terms of service — are hiding something.
4. A medical director is named with verifiable credentials. The medical director sets clinical protocols, reviews adverse events, and bears ultimate clinical responsibility. If the platform can't name this person, either nobody holds that role or the person holding it doesn't want their name attached. Both are problems.
5. The platform has a physical business address on file. Not a P.O. box. Not a registered agent's office. A real address where legal service can be effected and where a regulatory body can conduct an inspection if warranted. Check the secretary of state business filings in the company's state of incorporation.
Section B: Pharmacy sourcing and drug quality (5 points)
6. ★ The compounding pharmacy is named. This is the single most important transparency point in compounded GLP-1 telehealth. If the platform won't tell you which pharmacy compounds your medication, you cannot independently verify the drug's quality, the pharmacy's license status, or its inspection history. Full stop.
7. ★ The pharmacy holds a valid state license and, if applicable, nonresident pharmacy licenses in shipping states. Cross-reference the pharmacy name against the NABP database and the relevant state pharmacy board's online verification tool. A 503A pharmacy shipping across state lines should hold nonresident licenses in the states it ships to — or be operating in a state that doesn't require them (a shrinking list).
8. The pharmacy type (503A vs. 503B) is disclosed. A 503A pharmacy compounds individual prescriptions under state oversight. A 503B outsourcing facility operates under FDA registration and cGMP requirements. The 503B bar is higher. Neither is inherently unsafe, but patients deserve to know which standard applies to their medication. Platforms that say "our pharmacy is FDA-registered" when using a 503A are misleading you — 503A pharmacies are not FDA-registered in the same sense.
9. Third-party testing is mentioned or verifiable. Reputable compounding pharmacies conduct potency and sterility testing on each batch, often through a third-party lab. Some publish Certificates of Analysis. At minimum, the pharmacy or platform should be able to confirm that per-batch testing occurs. Silence on this point is a yellow flag.
10. Vial labeling includes lot number, expiration, and pharmacy name. When your medication arrives, the label should include the pharmacy name, the drug and concentration, a lot number, a beyond-use date, and storage instructions. Missing or incomplete labeling is both a regulatory violation and a patient safety risk — if you need to report an adverse event, the lot number is how the problem batch gets identified.
Section C: Clinical standards (5 points)
11. ★ The intake includes a real medical history. Comorbidities, current medications, allergy history, thyroid cancer family history, personal history of pancreatitis, MEN2 syndrome screening, pregnancy status. The Yale study found platforms approving patients with disclosed contraindications in their intake forms. If the intake doesn't ask these questions — or asks them but doesn't act on the answers — the clinical review is theater.
12. ★ A titration protocol is documented and followed. Semaglutide and tirzepatide have manufacturer-recommended titration schedules for a reason: starting too high causes unnecessary side effects, and inadequate titration wastes the patient's money. A legitimate platform starts at the lowest dose and increases based on tolerance and response, with clinician review at each step.
13. A follow-up mechanism exists and is used. Post-prescribing follow-up — at minimum at dose-escalation points — is the clinical standard of care. Platforms that autoship without any clinician touchpoint after the initial prescription are running a subscription product, not a healthcare service.
14. Side-effect reporting reaches a clinician (not just a chatbot). If you report nausea, vomiting, or injection site reactions, does the message reach a licensed clinician? Or does it go to a customer service representative who sends you a scripted response? Test this before you need it.
15. Lab work is required or recommended. Baseline labs (at minimum: metabolic panel, A1c, lipid panel, thyroid function) are the clinical standard for initiating GLP-1 therapy. Not every platform requires them — some recommend them — but platforms that neither require nor mention labs are below the clinical standard of care.
Section D: Pricing and billing transparency (3 points)
16. All-in monthly cost is stated before checkout. The total monthly cost — including medication, consultation fee, shipping, and any membership fee — should be visible before you enter payment information. Platforms that break pricing into components that are only revealed at different stages of the funnel are using dark patterns.
17. Dose-escalation pricing is disclosed. Does the monthly cost increase as your dose increases? At some platforms, the introductory price applies only to the starting dose, and the cost jumps significantly at higher doses. This needs to be stated upfront, not discovered on your third refill.
18. Cancellation is straightforward. Post-FTC Click-to-Cancel rule (effective May 2025): cancellation must be as easy as signup. If you signed up online, you must be able to cancel online. Platforms that require a phone call, a waiting period, or multiple steps to cancel are violating federal regulation.
Section E: Trust signals and transparency (2 points)
19. The platform has no unresolved FDA warning letters. A warning letter isn't automatic disqualification — it's a finding that requires a response. What matters is whether the company responded, corrected the violation, and received a close-out letter. Unresolved warning letters — especially for marketing violations related to compounded drugs — indicate ongoing noncompliance.
20. Ad disclosure and affiliate relationships are transparent. If the platform pays affiliates (including sites like ours) for referrals, that should be disclosed. If the platform's "reviews" are written by paid partners, that should be disclosed. Transparency about the economic incentives in the information ecosystem is a trust signal, not a liability.
How to use this checklist
Print it. Open your current provider's website in another tab. Work through all 20 points. It takes about fifteen minutes. If you can't answer a question from the website alone, email or chat support and ask directly. How they respond — speed, specificity, defensiveness — tells you as much as the answer itself.
If your platform scores below 12, or fails any of the five critical (★) points, we'd encourage you to look at alternatives. Not because your current medication is necessarily unsafe, but because the platform's unwillingness to be transparent is itself a risk factor.
We update this checklist quarterly. The next revision (October 2026) will incorporate new state-level telehealth regulations expected in California and New York, and any changes to FDA compounding enforcement following the 503B bulks list comment period closure.
The full scoring data for every platform on our Watchlist is available on the Watchlist page. If your provider isn't listed, submit it for review.