Purpose:
This consent form outlines your agreement to participate in laboratory testing as part of your treatment while on weight loss medications, including GLP-1 (glucagon-like peptide-1 receptor agonists), through our telemedicine practice, BottumzUp Health & Wellness, LLC.
1. Understanding of Weight Loss Medications
I understand that I am being prescribed weight loss medications, such as GLP-1, as part of my treatment plan. These medications may require regular monitoring through laboratory tests to assess their effectiveness and monitor any potential side effects.
2. Laboratory Testing
As part of your treatment plan for GLP-1 or other weight loss medications, you may be required to complete certain laboratory tests before beginning therapy.
*I consent to the collection of laboratory samples (e.g., blood, urine) as necessary to monitor my response to weight loss medications. These samples may be drawn by a qualified healthcare professional at a designated laboratory for analysis. Bottumzup Health and Wellness currently uses QUEST Diagnostic Labs. In the event you have your laboratory samples drawn at another facility you are responsible for submitting your results to Bottumzup Health and Wellness, LLC. These tests are essential to ensure your safety and to assess your overall health status.
The specific laboratory requisites will be determined based on your individual health needs and may include blood tests to evaluate factors such as:
- Baseline metabolic parameters
- Kidney function
- Liver function
- Blood glucose levels, etc...
3. Sample Management
I understand that: My samples will be handled according to established protocols to ensure their integrity and confidentiality.
4. Communication of Results
I consent to receive laboratory results via telemedicine platforms, phone calls, or secure messaging as appropriate. I understand that my healthcare provider will discuss these results with me and how they may impact my treatment plan.
5. Right to Withdraw Consent
I acknowledge that I have the right to withdraw my consent for laboratory testing at any time. However, I understand that this may affect my treatment plan, as regular monitoring is important for my health while on weight loss medications.
6. Confidentiality
I understand that my laboratory results and related information will be kept confidential in accordance with applicable laws and regulations.
7. Questions and Concerns
I have had the opportunity to ask questions regarding this consent form, the laboratory testing process, and the weight loss medications, and my questions have been answered to my satisfaction.
By signing below, I consent to the laboratory testing outlined above and acknowledge that I have read and understood this consent form.