Alternative Treatments

I have been informed about alternative treatments and understand:

1. That we can leave the hormone levels alone.
2. We can use a natural approach such as weight loss and nutrition instead.
3. We can use alternative medications to increase your testosterone and other hormone levels vs using prescription testosterone and other hormones.

Most of the common side effects resolve with time. Many of these can be treated by changing your testosterone dose and adding other medications.

I acknowledge that I should take extreme precaution if I am to use topical testosterone products. If a child or women accidently is exposed to the testosterone cream/lotion on my body it could cause a significant increase in their hormone levels which could result in possible side effects.

Safety of Hormone Replacement

Available data supports the safety of testosterone replacement therapy in men, and it is of the opinion of HUTTO WELLNESS and DANIEL HUTTO, ARNP that treatment is safe, but there still remains controversy regarding the correlation between the use of testosterone replacement therapy and cardiovascular events such as but not limited to: strokes, heart attacks, and blood clots. Some studies have shown correlations between testosterone replacement therapy and cardiovascular disease while others show no correlation or even a benefit in preventing cardiovascular disease.

My Obligations and Representations

Any questions I have regarding this treatment have been answered to my satisfaction. I understand that I will be responsible for administering the hormones and/or medications prescribed to me if I do not have them administered to me in clinic. I also promise to comply with the dosages and frequency of medications prescribed to me.

I certify that I will maintain routine primary care services with HUTTO WELLNESS, Family Practice, or with another health care provider of my preference, or with a specialist for any other conditions I might have or am found to have. I will consult with HUTTO WELLNESS, Family Practice, an alternate provider, or specialist regarding any other condition I might have. I understand that if I do have an additional primary care provider then HUTTO WELLNESS and DANIEL HUTTO, ARNP will provide these services and refer you to an appropriate specialist or for additional screening as indicated. I agree to provide HUTTO WELLNESS, Family Practice with copies of lab work and diagnostic studies that are relevant to treatments being given.  I acknowledge that I am seeking care at HUTTO WELLNESS, Family Practice, for the specific services HUTTO WELLNESS offers. I acknowledge if I choose to not or am unable to establish HUTTO WELLNESS, Family Practice as my only primary care provider then I am here for my preferred care including testosterone replacement, hormone restoration, etc. and I will follow up with the assigned provider by my insurance company or the alternate primary care provider of my choice.

I have reviewed the mentioned risks and have determined the benefits outweigh the possible risks associated with hormone restoration and treatment with HUTTO WELLNESS. I release any claim in court or any type of complaint that could result from treatment with HUTTO WELLNESS and DANIEL HUTTO, ARNP and any other staff associated with HUTTO WELLNESS and will not hold liable to any provider or staff of HUTTO WELLNESS.

I understand that treatment modalities utilized by HUTTO WELLNESS might not be supported by scientific/medical literature and could be seen as experimental or based off anecdotal claims. Many medical providers, including endocrinologists and urologists, might see these types of treatments and not medically necessary.

Consent

I hereby authorize HUTTO WELLNESS and DANIEL HUTTO, ARNP and additional staff of HUTTO WELLNESS. to evaluate and treat conditions that I have consented for. I consent to obtaining blood work before my initial evaluation so hormone levels can be monitored, and appropriate treatment can be prescribed. I certify that I am signing this under my free will and am competent to make my own medical decisions.

Indemnification Clause

I agree to indemnify, defend, protect, and hold harmless DANIEL HUTTO, ARNP, HUTTO WELLNESS, medical providers employed by HUTTO WELLNESS, their respective officers, directors, employees, stockholders, assigns, successors and affiliates from, against and in respect of all liabilities, losses, claims, damages, judgements, settlement payments, deficiencies, penalties, fines, interest and costs, expenses suffered, sustained, incurred or paid by the indemnified parties, in connection with, results from or arising out of, directly or indirectly from DANIEL HUTTO, ARNP, medical providers employed by HUTTO WELLNESS, and HUTTO WELLNESS; rendering medical care, services, advice, and/or treatment, my failure to disclose all relevant information regarding my medical and physical condition, acts or omissions, of DANIEL HUTTO, ARNP, HUTTO WELLNESS, INC.; harm or injury resulting from medical care or pharmaceuticals provided directly or indirectly by DANIEL HUTTO, ARNP or HUTTO WELLNESS. I am aware of the potential side effects associated with the above treatments, accept all the risks involved in taking the medication and will not seek indemnification or damages from the indemnified parties.