Informed Consent

I am seeking weight loss treatment from Doc4Life and am providing this informed consent to confirm my understanding of the information given by the Company and my treating provider. I acknowledge the treatment options, including lifestyle changes and diet, and understand the risks involved.
I am participating voluntarily and not on behalf of anyone else. I am aware that I can refuse treatment at any time and will ask for further clarification if I do not fully understand the risks, benefits, and alternatives.
The treatment involves self-injecting semaglutide at home, based on my provider’s assessment and state’s criteria for weight loss treatment. My provider will prescribe semaglutide, which will be delivered to my home with instructions for use. If I have any issues, I will contact the Company’s medical professional.

Potential risks of the treatment include:

• Thyroid tumors: Seek immediate medical attention if you experience symptoms like neck lumps or swallowing difficulties.
• Pancreatitis: Report severe stomach pain, nausea, or fever right away.
• Gallbladder problems: Contact a professional if you have severe nausea, abdominal fullness, or yellowing of the skin.
• Diabetic retinopathy: Notify your provider if you have vision changes.
• Hypoglycemia: Be aware of low blood sugar, especially if using other blood sugar-lowering medications.
• Allergic reactions: Seek urgent help for severe reactions such as swelling or breathing difficulties.
• Acute kidney injury: Report symptoms like bloody urine or swelling immediately.

I have read and agree to the Informed Consent as well as the Privacy & Terms & Conditions.