Testosterone Therapy Disclosure & Informed Consent
I acknowledge that I have voluntarily requested testosterone optimization services through OptiPepRx. If a licensed provider determines therapy is appropriate, treatment may include testosterone replacement or related therapies based on clinical assessment and laboratory evaluation.
Important Information
-
Individualized Medical Decision: Therapy, dosing, and route of administration are determined by a licensed provider based on symptoms, medical history, and lab results. Treatment may require periodic monitoring and adjustments.
-
No Guarantee of Results: Symptom improvement varies. No specific outcomes are guaranteed.
-
Potential Side Effects & Risks: Risks may include acne/oily skin, hair changes, mood changes, swelling/fluid retention, increased red blood cell count (high hematocrit), elevated blood pressure, changes in cholesterol, breast tenderness, and worsening sleep apnea.
-
Fertility Considerations: I understand testosterone therapy may reduce fertility and sperm production. If I am actively trying to conceive, I agree to inform the provider before starting therapy.
-
Prostate & Cancer Considerations: I understand therapy may not be appropriate for individuals with certain prostate or breast cancer histories. Monitoring may be recommended based on my risk profile.
-
Blood Clot/Cardiovascular Considerations: I understand there may be cardiovascular and clotting risks in certain individuals. My provider will evaluate risk factors and determine appropriate monitoring.
-
Patient Responsibility: I agree to provide accurate medical history, follow dosing instructions, complete required labs, and report adverse symptoms (shortness of breath, chest pain, severe headaches, leg swelling, etc.).
-
Monitoring & Follow-Up: I understand ongoing lab monitoring may be required (e.g., testosterone levels, CBC/hematocrit, CMP, lipids, PSA when clinically indicated) and that therapy may be paused or adjusted based on results.
By proceeding, I confirm I have read and understood this disclosure and consent to medical evaluation and, if appropriate, treatment under the direction of a licensed provider.
View Full Testosterone Disclosure (PDF)
