Telehealth Consent

Medical Weight Loss Treatments Consent Form

Introduction

Our telehealth practice is committed to delivering exceptional care to patients across the United States. Specializing in medical weight loss treatments, we provide access to cutting-edge medications and expert guidance to help patients achieve their health and wellness goals.

Core Services

  • GLP-1 Medications: We offer advanced GLP-1 medications, including Semaglutide and Tirzepatide, recognized for their efficacy in promoting weight loss and improving overall health.

  • Telehealth Convenience: Patients receive consultations, prescriptions, and follow-up care entirely online, ensuring accessibility and convenience.

  • Personalized Treatment Plans: Each patient’s plan is tailored to their unique health needs and goals, ensuring optimal outcomes.

Operational Excellence

  • Nationwide Coverage: Our licensed providers serve patients in all 50 states, leveraging telehealth platforms to eliminate geographic barriers.

  • Rapid Prescription Fulfillment: We partner with trusted pharmacies to ensure medications are dispensed promptly, enhancing the patient experience.

  • Expert Team: Our network of experienced medical professionals specializes in weight loss and metabolic health, providing compassionate and evidence-based care.

GLP-1 Medications: Transforming Weight Loss

  • Semaglutide: Helps curb appetite, regulate blood sugar, and promote significant weight loss.

  • Tirzepatide: Combines GLP-1 and GIP receptor agonist properties for enhanced weight loss and metabolic benefits.

  • Evidence-Based: Both medications are FDA-approved for weight loss and supported by extensive clinical research.

Patient Journey

  1. Initial Consultation: Patients complete a comprehensive health assessment via our secure online platform.

  2. Provider Review: Our licensed providers review the patient’s medical history and create a personalized treatment plan.

  3. Prescription & Delivery: Medications are prescribed and shipped directly to the patient’s doorstep, ensuring a seamless process.

  4. Ongoing Support: Regular follow-ups ensure patients stay on track, with adjustments made to optimize results.

Patient Waiver of Liability and Consent Agreement

1. Elective Nature of Treatment

The patient acknowledges and agrees that all treatments provided are elective and not medically necessary. Participation is entirely voluntary.

2. No Primary Care Substitution

The patient understands that this practice does not act as their primary care provider. Routine medical care and emergencies must be handled by the patient’s primary care provider.

3. Assumption of Risk

The patient voluntarily assumes all risks associated with the treatments and agrees to disclose accurate medical history, including medications and conditions.

4. Waiver of Liability

The patient irrevocably waives and releases all liability, claims, and damages arising from treatments, including but not limited to:

  • Negligence in the delivery of care.

  • Complications or adverse effects.

  • Dissatisfaction with treatment outcomes.

5. No Legal Recourse

The patient agrees not to pursue legal action or claims against the practice for any adverse outcomes or dissatisfaction.

6. No Refund Policy

All payments are final and non-refundable.

7. Harm Prevention and Non-Disparagement

The patient agrees not to harm the practice’s reputation through negative reviews, false claims, or misinformation.

8. Informed Consent

The patient affirms they have had all questions answered and provide informed consent to proceed.

9. Governing Law

This agreement is governed by the laws of the state where the treatment is provided.

10. Binding Nature of Agreement

By proceeding with treatments through this platform, patients acknowledge agreement to these terms and conditions.

Semaglutide Weight Loss Injection Consent

The patient consents to the administration of Semaglutide Weight Loss Injections and affirms:

  • They meet eligibility criteria and have no contraindications such as:

    • Medullary Thyroid Carcinoma (MTC)

    • Multiple Endocrine Neoplasia, type 2 (MEN 2)

    • Prior allergic reactions to Semaglutide

  • They have disclosed all medications and medical history to the provider.

  • They will adhere to all pre- and post-treatment instructions.

Potential Side Effects:

  • Common: Nausea, vomiting, diarrhea, constipation, abdominal pain.

  • Less Common: Allergic reactions, vision changes, severe nausea, kidney injury.

  • Patients must report serious side effects immediately.

By accessing and using our services, patients confirm their understanding and acceptance of this consent form and its terms.

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