Copy it, print it, or download the PDF
Make it easy for your doctor to say yes.
The Bridge is brand new, and most clinicians haven't prescribed through it yet. The Doctor Request Packet turns your screener answers into something your doctor can act on in minutes — including the exact prescribing steps your clinician needs.
What's free, and what the $39 adds
The screener and your doctor message are free — run it, copy the message, send it today, no charge. The packet is for the next step: giving your doctor everything they need to act on a program they've likely never prescribed through.
The clinician prescribing sheet
Packet only — the centerpiece
This is the page that helps you get where you're going — better health and getting back to the things you want to do — with fewer detours along the way. It puts the specifics your doctor needs to send the request correctly the first time, so a small detail being off is less likely to bounce it back and delay your start. It's the part your doctor acts on — and the part you can't get from the free screener.
A one-page patient summary
Packet only
Your coverage type, BMI history, relevant diagnoses, and how they compare to the published criteria pathways — organized the way a clinic reads it, with a documentation checklist and visit questions.
PDF download & print formatting
Packet only
One clean document to attach in your patient portal, email ahead of your visit, or hand across the desk.
Your message, in your voice
Free with the screener
A warm, clear portal message ready to paste into MyChart, Healow, or an email. Free because asking the question should cost nothing — the packet exists to make the answer easy.
The Doctor Request Packet
$39
one time — vs. $400+ every month at self-pay
Complete the free screener first — you'll see your result and doctor message at no cost. The $39 unlocks the full packet: the formatted summary, the clinician reference sheet, and PDF download.
Useful, or your money back. Use the packet — and if it doesn't make your doctor visit easier, email us within 14 days for a full refund. No questions, and you keep the files.
Check our work: every fact in the packet is cited to a published CMS document number — like the prescriber fact sheet, CMS Product No. 12235 — so you and your doctor can verify each step at the source.
Start with the free screenerPayment is processed by Stripe Checkout; we never see your card number. The charge appears on your card statement as COLUMBIA SOFTWARE LLC — that's us, Columbia Software Works LLC, the company that operates this site. A purchase doesn't include medical care, prescribing, prior authorization submission, or any coverage outcome — those are between your clinician and the program.
Why get it now?
The Bridge is live — prescriptions can go out today, and the program window runs only through December 2027. Medicare appointments often book two to six weeks out, so the sooner you book, the sooner you're seen. Your starting weight may take some digging to document. And your doctor will much prefer reviewing a new program's prescribing rules before your visit than during it. Patients who arrive prepared are the ones whose prescriptions go out first — the packet is how you become one of them.
Why the clinician sheet matters
The Bridge works differently from regular Part D, and there are several specific details that all have to be done correctly for the prescription to go through. Get any one of them off and the request can stall or come back unapproved — a sequence that surprises offices the first time. The clinician sheet in the packet lays out exactly what those details are and the order they happen in, so a doctor who's never touched the program can get it right in one pass instead of three.
Payment and privacy
Your health answers stay in your browser — they're never sent to our servers. The personalized part of your packet is built right on your device; after Stripe verifies your payment, the clinician reference section (the same CMS-based prescribing steps for everyone) is delivered to complete it. We don't store your health answers, and we never ask for your Medicare number.
Refunds
You're covered two ways. If the packet isn't useful, email us within 14 days for a full refund — no questions asked, and you keep the files. And if a duplicate charge or a site error ever prevents access, we'll make that right too. Refunds aren't tied to whether a clinician prescribes or whether coverage is approved — we can't control those outcomes and don't promise them. Details in the Terms of Use.
Who's behind this
GLP1BridgeHelp.com is built by Kevin, a software developer who spent weeks reading the CMS source documents so you don't have to, and operated by his company, Columbia Software Works LLC — independent, not Medicare, not a drug maker, not an insurer. He built it because the Bridge is genuinely hard to navigate: the rules are spread across multiple CMS documents, and the program is so new that most doctors and pharmacies haven't seen it yet. Every fact here is drawn from published CMS materials, and we cite the exact document numbers — like the prescriber fact sheet, CMS Product No. 12235 — so you can check our work. When CMS updates the rules, we update the site and log it on the criteria changelog.
We never ask for your Medicare number, and your screener answers stay in your browser. Questions? Contact us.