Consent to Treatment
  • Consent to Treatment

    Please review the information below and provide your acknowledgment and agreement to the terms of care at Wellness Transformation, LLC.
  • This document is intended to inform you that care provided at Wellness Transformation, LLC is directed by an autonomous nurse practitioner, licensed and board certified in the state of Florida. Autonomous Advanced Practice Registered Nurses (APRNs) have met requirements defined by the Florida Board of Nursing to practice in a Primary Care/Family Practice role without the direction or supervision of a medical director/physician. Evaluation and treatment will be confined to uncomplicated/minor acute illness for adults (upper respiratory infections/urinary tract infections), school/camp/sports physicals aged 12 and older (children without chronic illness/pre-diagnosed cardiac/respiratory disease and not needing ECG evaluation- required in 1st year sports eval high school), neck/back pain evaluations/imaging orders/treatment plans (excluding workers compensation, auto accidents, or personal injury cases), and medical weight loss for adults (to include diet and exercise recommendations). It is advised that you maintain healthcare insurance and follow routinely with a designated primary care provider for ongoing medical concerns and chronic illnesses.   In the event of a medical emergency, you should seek prompt treatment by dialing 911 or call your routine medical provider for guidance. Further, it is encouraged that you share your Wellness Transformation encounters with your primary care provider and medical records of encounters will be sent to a designated provider with your consent/approval.

    Wellness Transformation has the right to deny care and defer to primary care provider if a patient reports significant/multiple medical comorbidities, excessive food/drug allergies, or if requiring additional follow up to an acute medical concern (such as lab work, vital signs, and imaging).

    Wellness Transformation does not accept healthcare insurance and is “cash only” (payments via Zelle, Venmo). Fees are based on services rendered and are subject to change. Fees will be discussed prior to your visit. In most cases, fees are comparable to insurance co-payments for specialty care.

    By signing below, you understand and agree to the above terms.

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