Stuff You Gotta Know 

Alrighty, here comes the nitty gritty. Regardless of what you're interested in, we got some stuff you need to read. Please read the following few pages carefully!

 

Ozempic® Information  

Ozempic® is an FDA-approved prescription medication primarily used to manage type 2 diabetes. It contains the active ingredient semaglutide, which belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. Although not FDA-approved for obesity, several studies have shown Ozempic®, paired with exercise and a reduced-calorie diet, to be effective in aiding weight loss. 

 

Usage and Dosage

Ozempic® is available as a pre-filled pen for subcutaneous (under the skin) injection.

 

Your healthcare provider will determine the appropriate dosage for you based on your individual needs.The medication is typically injected once a week on the same day each week. Follow the instructions provided by your healthcare provider or refer to the patient information leaflet for detailed instructions on how to use the pen and administer the medication.

 

Possible Side Effects

As with any medication, Ozempic® may cause side effects. It is important to be aware of these potential effects, although not everyone experiences them. Contact your healthcare provider if you have any concerns about side effects. 

 

Common side effects may include nausea, diarrhea, vomiting, headache, abdominal pain, decreased appetite, constipation. Possible side effects of subcutaneous injections may include itching and burning at site of administration with or without thickening of the skin.

 

These side effects are usually mild and tend to improve over time. However, inform your healthcare provider if any of these side effects persist or worsen, or if you notice any side effects not listed above. Get medical help right away if you notice any symptoms of a serious allergic reaction, including rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

 

Note: This is not an exhaustive list of side effects. Refer to the patient information leaflet (or the prescribing information here: https://www.novo-pi.com/ozempic.pdf) for a comprehensive list of potential side effects and consult your healthcare provider for personalized guidance.

 

Important Precautions and Warnings

Inform your healthcare provider about any existing medical conditions, including allergies, pancreatitis, diabetic retinopathy, thyroid problems, and kidney or liver disease.

 

Discuss all medications, supplements, and herbal remedies you are taking with your healthcare provider to avoid potential drug interactions.

 

If you are pregnant, planning to become pregnant, or breastfeeding, consult your healthcare provider before using Ozempic®.

 

Attend regular check-ups as advised by your healthcare provider to monitor your progress and address any concerns.

 

It is generally recommended to limit alcohol consumption while taking Ozempic®. Drinking alcohol can affect blood sugar levels and increase the risk of certain side effects, such as low blood sugar (hypoglycemia) or an upset stomach. Therefore, it is advisable to consult your healthcare provider regarding the specific guidelines for alcohol consumption while on Ozempic®.

 

Contraindications

Do not use Ozempic® if:

- You are allergic to semaglutide or any of the other ingredients in the medication.
- You have a personal or family history of medullary thyroid carcinoma (MTC).
- You have multiple endocrine neoplasia syndrome type 2 (MEN 2).
- You are taking other GLP-1 agonist medicines such as: Adlyxin®, Byetta®, Bydureon®, Rybelsus®, Trulicity®, Victoza®, Wegovy® Maunjaro® (THIS IS NOT AN ALL-INCLUSIVE LIST).

 

If any of these apply to you, inform your healthcare provider.

 

Note: Your healthcare provider at ZipFit can provide personalized advice based on your individual circumstances and any other medications you may be taking. 

 

IF YOU HAVE ANY QUESTIONS AS TO THE RISKS OR HAZARDS OF THIS TREATMENT, OR ANY QUESTIONS CONCERNING THIS PROPOSED TREATMENT OR OTHER POSSIBLE TREATMENTS, ASK NOW BEFORE SIGNING THIS CONSENT FORM. 

 

Ozempic® Information  

Ozempic® is an FDA-approved prescription medication primarily used to manage type 2 diabetes. It contains the active ingredient semaglutide, which belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. Although not FDA-approved for obesity, several studies have shown Ozempic®, paired with exercise and a reduced-calorie diet, to be effective in aiding weight loss. 

 

Usage and Dosage

Ozempic® is available as a pre-filled pen for subcutaneous (under the skin) injection.

 

Your healthcare provider will determine the appropriate dosage for you based on your individual needs.The medication is typically injected once a week on the same day each week. Follow the instructions provided by your healthcare provider or refer to the patient information leaflet for detailed instructions on how to use the pen and administer the medication.

 

Possible Side Effects

As with any medication, Ozempic® may cause side effects. It is important to be aware of these potential effects, although not everyone experiences them. Contact your healthcare provider if you have any concerns about side effects. 

 

Common side effects may include nausea, diarrhea, vomiting, headache, abdominal pain, decreased appetite, constipation. Possible side effects of subcutaneous injections may include itching and burning at site of administration with or without thickening of the skin.

 

These side effects are usually mild and tend to improve over time. However, inform your healthcare provider if any of these side effects persist or worsen, or if you notice any side effects not listed above. Get medical help right away if you notice any symptoms of a serious allergic reaction, including rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

 

Note: This is not an exhaustive list of side effects. Refer to the patient information leaflet (or the prescribing information here: https://www.novo-pi.com/ozempic.pdf) for a comprehensive list of potential side effects and consult your healthcare provider for personalized guidance.

 

Important Precautions and Warnings

Inform your healthcare provider about any existing medical conditions, including allergies, pancreatitis, diabetic retinopathy, thyroid problems, and kidney or liver disease.

 

Discuss all medications, supplements, and herbal remedies you are taking with your healthcare provider to avoid potential drug interactions.

 

If you are pregnant, planning to become pregnant, or breastfeeding, consult your healthcare provider before using Ozempic®.

 

Attend regular check-ups as advised by your healthcare provider to monitor your progress and address any concerns.

 

It is generally recommended to limit alcohol consumption while taking Ozempic®. Drinking alcohol can affect blood sugar levels and increase the risk of certain side effects, such as low blood sugar (hypoglycemia) or an upset stomach. Therefore, it is advisable to consult your healthcare provider regarding the specific guidelines for alcohol consumption while on Ozempic®.

 

Contraindications

Do not use Ozempic® if:

- You are allergic to semaglutide or any of the other ingredients in the medication.
- You have a personal or family history of medullary thyroid carcinoma (MTC).
- You have multiple endocrine neoplasia syndrome type 2 (MEN 2).
- You are taking other GLP-1 agonist medicines such as: Adlyxin®, Byetta®, Bydureon®, Rybelsus®, Trulicity®, Victoza®, Wegovy® Maunjaro® (THIS IS NOT AN ALL-INCLUSIVE LIST).

 

If any of these apply to you, inform your healthcare provider.

 

Note: Your healthcare provider at ZipFit can provide personalized advice based on your individual circumstances and any other medications you may be taking. 

 

IF YOU HAVE ANY QUESTIONS AS TO THE RISKS OR HAZARDS OF THIS TREATMENT, OR ANY QUESTIONS CONCERNING THIS PROPOSED TREATMENT OR OTHER POSSIBLE TREATMENTS, ASK NOW BEFORE SIGNING THIS CONSENT FORM. 

 

Ozempic®/Semaglutide Information  

Ozempic® is an FDA-approved prescription medication primarily used to manage type 2 diabetes. It contains the active ingredient semaglutide, which belongs to a class of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. Although not FDA-approved for obesity, several studies have shown Ozempic®, paired with exercise and a reduced-calorie diet, to be effective in aiding weight loss. 

ZipFit offers both brand name Ozempic® and a semaglutide compound, which contains semaglutide and a small dose of vitamin B12 (0.5mg/ml per 3mls vial). 

 

Usage and Dosage

Semaglutide is available as a pre-filled pen for subcutaneous (under the skin) injection.

 

Your healthcare provider will determine the appropriate dosage for you based on your individual needs.The medication is typically injected once a week on the same day each week. Follow the instructions provided by your healthcare provider or refer to the patient information leaflet for detailed instructions on how to use the pen and administer the medication.

 

Possible Side Effects

As with any medication, semaglutide may cause side effects. It is important to be aware of these potential effects, although not everyone experiences them. Contact your healthcare provider if you have any concerns about side effects. 

 

Common side effects may include nausea, diarrhea, vomiting, headache, abdominal pain, decreased appetite, constipation. Possible side effects of subcutaneous injections may include itching and burning at site of administration with or without thickening of the skin.

 

These side effects are usually mild and tend to improve over time. However, inform your healthcare provider if any of these side effects persist or worsen, or if you notice any side effects not listed above. Get medical help right away if you notice any symptoms of a serious allergic reaction, including rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

 

Note: This is not an exhaustive list of side effects. Refer to the patient information leaflet for a comprehensive list of potential side effects and consult your healthcare provider for personalized guidance.

 

Important Precautions and Warnings

Inform your healthcare provider about any existing medical conditions, including allergies, pancreatitis, diabetic retinopathy, thyroid problems, and kidney or liver disease.

 

Discuss all medications, supplements, and herbal remedies you are taking with your healthcare provider to avoid potential drug interactions.

 

If you are pregnant, planning to become pregnant, or breastfeeding, consult your healthcare provider before using semaglutide.

 

Attend regular check-ups as advised by your healthcare provider to monitor your progress and address any concerns.

 

It is generally recommended to limit alcohol consumption while taking semaglutide. Drinking alcohol can affect blood sugar levels and increase the risk of certain side effects, such as low blood sugar (hypoglycemia) or an upset stomach. Therefore, it is advisable to consult your healthcare provider regarding the specific guidelines for alcohol consumption while on semaglutide.

 

Contraindications

Do not use semaglutide if:

- You are allergic to semaglutide or any of the other ingredients in the medication.
- You have a personal or family history of medullary thyroid carcinoma (MTC).
- You have multiple endocrine neoplasia syndrome type 2 (MEN 2).
- You are taking other GLP-1 agonist medicines such as: Adlyxin®, Byetta®, Bydureon®, Rybelsus®, Trulicity®, Victoza®, Wegovy® Maunjaro® (THIS IS NOT AN ALL-INCLUSIVE LIST).

 

If any of these apply to you, inform your healthcare provider.

 

Note: Your healthcare provider at ZipFit can provide personalized advice based on your individual circumstances and any other medications you may be taking. 

 

IF YOU HAVE ANY QUESTIONS AS TO THE RISKS OR HAZARDS OF THIS TREATMENT, OR ANY QUESTIONS CONCERNING THIS PROPOSED TREATMENT OR OTHER POSSIBLE TREATMENTS, ASK NOW BEFORE SIGNING THIS CONSENT FORM. 

Privacy and Confidentiality Notice

We understand that many patients are concerned about the privacy surrounding their decision to use medication. Your decision is a personal one and it is our pledge that we will safeguard the information you provide to the best of our abilities. Please review the following carefully. If you have any questions, please do not hesitate to contact us.

 

Our efforts to safeguard your personal and medical information include training our staff on the principals and importance of patient confidentiality, and keeping patient charts and photographs safe and secure. A description of the information typically collected is listed here: 

 

• To ensure the highest quality of medical care, you will be asked to share medical history information such as previous surgeries, allergies to medications, and general health status.
• Additionally, you will be asked to discuss with ZipFit's medical team the reasons for your outreach and your goals. We may record this information in our chart notes. 
• We require you to submit digital photographs in this intake form, and we may ask you to share digital photographs in the future. These assist with candidate assessment and treatment progress evaluation. These photos will not be shared with anyone outside our medical practitioners unless we get written consent from you to share otherwise. In the event that we consider using your photos for marketing purposes in the future, we will inform you in advance and request your additional consent by signing a separate document.
• For tracking and invoicing purposes, you will be asked to share personal information such as name, address, phone numbers, email, social security number, and credit card number(s). Again, we take the utmost care in handling this information. 

 

Notice of Privacy Practices

This notice describes how health information about you (as a patient of ZipFit) may be used and disclosed and how you can get access to your health information. This is by the Privacy Regulations created as a result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

 

Our Commitment to Your Privacy:
Our practice is dedicated to maintaining the privacy of your health information. We are required by law to maintain the confidentiality of your health information.

 

We realize that these laws are complicated, but we must provide you with the following important information:

 

Use and Disclosure of Your Health Information in Certain Special Circumstances:

 

The following circumstances may require us to use or disclose your health information:

 

1. To public health authorities and health oversight agencies that are authorized by law to collect information.
2. Lawsuits and similar proceedings in response to a court or administrative order.
3. If required to do so by law enforcement official.
4. When necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. We will only make disclosures to a person or organization able to help prevent the threat.
5. Right to a copy of this note. You are entitled to receive a copy of this Note of Privacy Practices. You may ask us to give you a copy of this notice anytime. To obtain a copy of this notice, contact our front desk receptionist.
6. Right to file a complaint. If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the Department of Health and Human Services. To file a complaint with our practice, contact David M. Alessi, M.D., F.A.C.S. All complaints must be submitted in writing. You will not be penalized for filing a complaint. 
7. Right to provide an authorization for other uses and disclosures. Our practice will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. 

 

If you have questions regarding this notice or our health information privacy policies, please contact ZipFit. 

 

Notice to Consumers

Medical doctors are licensed and regulated by the Medical Board of California 

(800) 633 2322

www.mbc.ca.gov

 

Data Breach Protocol

At ZipFit, we prioritize the security and confidentiality of your personal information. We employ robust encryption and industry-standard security measures to protect your data within our system and digital tools. While we strive to maintain the utmost security, it is important to acknowledge that no method of data transmission or storage is entirely foolproof.

 

In the unlikely event of a data breach, we are committed to promptly notifying all affected users in accordance with applicable laws and regulations, including the California Consumer Privacy Act (CCPA). We will take immediate action to mitigate the impact of the breach and provide guidance on steps you can take to protect your interests.

 

Your trust is of utmost importance to us. By using our services, you acknowledge and accept the inherent risks associated with data transmission and storage. We appreciate your confidence in ZipFit and remain dedicated to safeguarding your privacy and personal information.

Telemedicine

Telemedicine consultations may be conducted over landline phone, cellular phone, online chat, email, and/or video conferencing, such as Zoom. Should a practitioner deem a virtual appointment required, the appointment must be scheduled and confirmed by ZipFit prior to the appointment. 

 

Prior to the telemedicine consultation, this intake form must be completed and submitted. If additional information is requested, that must also be provided. 

 

Information shared during the telemedicine consultation will be documented appropriately in your medical record by our practitioners. 

 

A telemedicine consultation may include the total interchange of online inquiries and other communications associated with this single patient encounter, subject to determination of the practitioner.

Amazing! Thanks for your response!

After hitting submit, you may not see that satisfying "we've received your responses" page. That might be because your browser is blocking pop-ups.

Fret not! You'll be receiving a confirmation email from us shortly. If you don't, however, please shoot us an email at hello@zip.fit. We'll get right on it!