request from Pro-Health & Wellness and/or Casandra Way, FNP, to prescribe for me Bioidentical Hormone Replacement Therapy (BHRT) and or Peptide therapy.
I understand that compounded BHRT and Peptide therapy is not specifically approved by the FDA for preventive medicine and my request for BHRT is off-label.
I understand that the medical literature indicates that there may be health benefits to the use of BHRT and peptide therapy and its long-term effects are undetermined.
I understand that (insert facility/physician) cannot guarantee any results or that there will be no harm.
The potential health risks and benefits of using BHRT have been explained to me to my satisfaction.
I understand that any hormone replacement including BHRT has the potential to increase my risk of breast cancer and for this reason it is recommended that I have routine mammograms every 1-2 years
after age 40 and prior to starting HRT.
I understand that estrogen alone can cause uterine cancer and that I will need to take this with progesterone for uterine protection.
I understand that while Testosterone, BHRT and peptide therapy has been shown in medical literature to have benefits in women, that it is not currently FDA approved for the use in women and that if I choose to undergo this treatment, it is an off label treatment.
I understand that this treatment requires routine lab monitoring.
I understand that BHRT and peptide therapy is purely elective and that it may not be deemed medically necessary by insurance companies.
