Oxytocin Nasal Spray
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PURPOSE OF TREATMENT I, the undersigned, am requesting treatment with Oxytocin Nasal Spray, provided by Dr. David Mahjoubi, MD. I understand that oxytocin is a naturally occurring hormone associated with social bonding, mood regulation, and stress relief. Oxytocin Nasal Spray may be prescribed to promote well-being, relaxation, and emotional connectivity. 2. POTENTIAL BENEFITS I understand that Oxytocin Nasal Spray may offer the following potential benefits: Enhanced mood and relaxation Reduced feelings of stress and anxiety Improved emotional bonding and social interactions Potential improvement in sleep qualityPossible reduction in perception of pain However, I acknowledge that individual responses to Oxytocin Nasal Spray may vary, and there is no guarantee that I will experience these benefits. 3. POTENTIAL SIDE EFFECTS AND RISKS I understand that Oxytocin Nasal Spray is generally considered safe, but potential side effects may include: Mild nasal irritation or discomfort Drowsiness or fatigue Headache Nausea Changes in mood, including mild euphoria or emotional sensitivity I also acknowledge that rare but serious risks may include: Increased risk of social or emotional dependency Unpredictable emotional responses Potential interaction with other medications or supplements - I have informed Dr. David Mahjoubi of all medications and supplements I am currently taking. I understand that Oxytocin Nasal Spray may interact with certain medications, including antidepressants and mood stabilizers. 4. CONTRAINDICATIONS I understand that Oxytocin Nasal Spray may not be appropriate for individuals with certain medical conditions or those taking specific medications. I have disclosed my complete medical history to Dr. David Mahjoubi, MD to ensure safe treatment. 5. NO GUARANTEE OF BENEFITS I acknowledge that Dr. David Mahjoubi, MD makes no guarantee, either express or implied, regarding the results of Oxytocin Nasal Spray. I understand that the effects of the spray may vary and that no particular outcome is assured. 6. ALTERNATIVE TREATMENT OPTIONS I understand that Oxytocin Nasal Spray is one of several options for managing mood, anxiety, or emotional well-being. I am choosing to proceed with Oxytocin Nasal Spray with full knowledge of its potential benefits and risks. 7. VOLUNTARY CONSENT I have read and fully understand the information provided in this consent form. I have had the opportunity to discuss Oxytocin Nasal Spray treatment with Dr David Mahjoubi if I so choose and have had all of my questions answered to my satisfaction. By signing this form, I consent to purchase and use Oxytocin Nasal Spray. I understand that I may discontinue use at any time but agree to consult with my provider if I experience any concerning side effects or reactions.
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Oxytocin Nasal Spray
100 Units per mL. Total 24 mL.
$
150.00
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