Loading
Purpose and Nature of Pellet Therapy: I understand that Down-to-Earth Wellness Center offers Bioidentical Hormone Replacement Therapy (BHRT) in the form of subcutaneous pellets, which are designed to provide a consistent release of hormones over time to restore hormonal balance and support overall wellness. This therapy may include testosterone and/or estrogen pellets, depending on individual needs. The pellets are inserted under the skin in a simple in-office procedure. BHRT is used to alleviate symptoms related to hormone imbalances such as fatigue, mood swings, low libido, poor sleep, mental fog, and decreased muscle mass or bone density.
Benefits of Pellet Therapy: Potential benefits of bioidentical hormone pellet therapy include improved energy, enhanced mood and mental clarity, better sleep, increased libido, improved muscle tone, reduced symptoms of menopause or andropause, and support for bone and cardiovascular health. Results may vary based on individual response.
Risks and Side Effects: While generally well tolerated, I understand that BHRT with pellets may involve certain risks and side effects. These may include, but are not limited to, bruising, swelling, pain, or infection at the insertion site, pellet extrusion, hormonal fluctuations, acne, hair growth or loss, mood changes, breast tenderness, or changes in libido. Rare complications may also include allergic reaction or adverse changes in cholesterol or liver function. Hormone therapy is not recommended for certain individuals, and I understand it is my responsibility to fully disclose my medical history.
Medical Disclosure: I confirm that I have provided a full and accurate medical history, including all medications, supplements, allergies, and known health conditions. I understand that this information is essential for safe and effective treatment planning. I agree to undergo appropriate lab testing as recommended to monitor hormone levels and overall health during therapy.
Alternative Options: I understand that alternatives to pellet therapy include oral, topical, or injectable forms of hormone replacement therapy, or choosing not to pursue hormone therapy at all. I acknowledge that I have been informed of these options and choose to proceed with pellet therapy voluntarily.
Consent and Release of Liability: By signing the Consent & Authorization Summary Signature Page, I confirm that I have read and understood this consent form. I have had the opportunity to ask questions and receive satisfactory answers. I voluntarily consent to receive bioidentical hormone pellet therapy at Down-to-Earth Wellness Center. I understand that no guarantees have been made regarding the outcome, and that results may vary. I agree to release and hold harmless Down-to-Earth Wellness Center, its providers, and staff from any liability related to this therapy, except in cases of gross negligence or malpractice.