Scored questionnaires
Create multi-step intake forms with sum or formula scoring, score ranges, result messages, and redirects.
MediAsk
Scored medical intake for your Shopify store
Build questionnaires that collect BMI, symptoms, and consent, then route shoppers by score.
What MediAsk does
MediAsk helps medical and GLP-1 merchants qualify shoppers on the storefront with branded, scored questionnaires managed inside Shopify admin.
BMI and clinical fields
Collect ethnicity, weight, height, symptoms, contact details, address fields, and consent in one flow.
Storefront theme block
Add the questionnaire to your theme and style it with presets, colors, or custom CSS.
Answers in admin
Review submissions in Shopify and export answers as CSV when you need them.
Basic and Premium
Choose MediAsk Basic for core intake questionnaires, or MediAsk Premium for branding controls, image questions, and submission forwarding.
Basic
$15USD / month
- Build scored storefront questionnaires
- Collect BMI, symptoms, contact details, and consent
- Style questionnaires with theme presets and colors
- Review submissions and export CSV from admin
Premium
$30USD / month
- Everything in Basic
- Image questions in questionnaires
- Custom brand logo on the storefront questionnaire
- Hide MediAsk branding on the storefront
- Forward each submission to your external API
Support
Need help installing MediAsk, publishing a questionnaire, or upgrading to Premium? Email us and we will get back to you.
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