Informed Consent to Treat
I consent to evaluation and treatment by Amber Tomse, APRN, D.B.A. Beauty Refined, LLC for hormone-related concerns. I understand therapies may include off-label use of medications for optimization and wellness.
I voluntarily consent to evaluation, lab testing, and treatment at Beauty Refined, LLC under Amber Tomse, APRN.
Alternative Treatments I understand the alternatives:
(1) No treatment,
(2) Lifestyle/nutrition changes,
(3) Non-testosterone medication.
Side Effects and Potential Risks:
Common side effects include acne, balding, high blood pressure, fluid retention, infertility, and increased hematocrit. Possible risks include cardiovascular events and prostate changes.
Indemnification Clause:
I agree to indemnify and hold harmless Beauty Refined, LLC, Amber Tomse, APRN, and affiliates from claims arising from treatment.
Laboratory Testing
Baseline/follow-up labs may include: CBC, CMP, Lipid Panel, Thyroid Panel, PSA, DHEA-S, Testosterone, Estradiol, LH, FSH, IGF-1, CRP, Ferritin, DHT, Estrone, Progesterone, Cortisol, Vitamin D
Safety and Monitoring
I understand ongoing lab monitoring and primary care follow-up are required for safety.
I will follow dosage instructions, maintain primary care, and understand Beauty Refined provides elective care only.