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Frequently asked questions
Will my order definitely be approved? +
No, and that is intentional. Dr. Rachel personally reviews every intake form before any protocol is authorized. Payment authorization does not guarantee dispensing. If your intake reveals a clinical concern, she will reach out directly. If Dr. Rachel doesn't approve your protocol, the payment hold is released and you are never charged.
What happens if my order isn't approved? +
If Dr. Rachel determines that a protocol is not appropriate for you based on your intake, your order will not be dispensed. If Dr. Rachel doesn't approve your protocol, the payment hold is released and you are never charged. She may also reach out to discuss alternatives or request additional information before making a final decision.
How does payment work? +
Your payment method is authorized at checkout but the charge is not captured until Dr. Rachel approves your protocol. If your order is not approved, the authorization is released and you are never charged.
Is this a subscription? +
Every first Tides order defaults to a one-time purchase. At checkout you can optionally enroll in Ongoing Care, we prepare your reorder on your cycle (40, 90, or 120 days depending on your protocol). Dr. Rachel prescribes the protocol and her prescription authorizes the term; every 4th refill returns to her for a scheduled check-in, and she can adjust that cadence for your specific care. It is entirely opt-in, never default, and you can pause or cancel anytime in your patient portal. This is not a monthly consumer subscription, it is a clinical care relationship with cycle-based refills. Pricing is the same as a one-time order; the value is convenience and clinical continuity, not a discount.
How do refills work? +
Two paths. Manual reorder: log into your patient portal and tap "Refill" anytime you need one, one click sends it to Dr. Rachel for a quick refill review. Faster than the first order because your clinician already has your history. Ongoing Care: on your protocol's cycle we email you when you're due for a refill, you confirm nothing has changed with one tap, Dr. Rachel signs off, and we ship. Refills only fire when you tap and Rachel signs. Nothing bills in the background.
Is this covered by insurance? +
No. Compounded therapies are not covered by insurance. All orders are paid out-of-pocket at the time of checkout. Some patients use HSA or FSA funds, check with your plan administrator to confirm eligibility.
How long does delivery take? +
If your protocol is approved, compounds are prepared at a licensed compounding pharmacy and shipped directly to your door. Allow 7-10 business days from approval to delivery. You'll receive a tracking number via email as soon as your order ships.
Can I do this without visiting a clinic? +
Yes. The entire process is remote. The assessment, intake form, clinical review, and delivery are all handled without a clinic visit.
What GLP-1 options does Tides offer? +
Semaglutide as a once-weekly injection, prepared per your prescription by a US 503A licensed compounding pharmacy. Tirzepatide as a once-weekly injection (a dual GIP and GLP-1 agonist with broader appetite and metabolic effect than a GLP-1 alone). Tirzepatide as a daily oral tablet for patients who prefer to avoid injections. Dr. Rachel picks the one that fits your history, labs, and preference. Compounded GLP-1s are not FDA-approved and are not the same product as brand-name GLP-1s.