I certify that the information provided above is accurate and complete to the best of my knowledge. I understand that it is important to inform REVV Health of significant changes to my health, medications, or medical history while under care.
I understand that testosterone therapy will be considered based on my symptoms, health history, laboratory findings, treatment goals, and my provider's clinical judgment.
I understand that individual response to treatment varies and that no specific outcome can be guaranteed.
Potential effects and risks of testosterone therapy may include changes in red blood cell production/hematocrit, acne or oily skin, hair growth or hair loss in genetically susceptible individuals, fluid retention, libido or sexual function, prostate or urinary symptoms, breast tissue, cholesterol or other laboratory markers, and suppression of the body's natural testosterone production.
I understand that testosterone therapy can suppress sperm production and may significantly reduce fertility. If maintaining or establishing fertility is important to me, I understand that I should discuss this with my provider before beginning treatment.
I understand that appropriate laboratory monitoring and follow-up are important components of testosterone therapy and that my treatment may be adjusted based on my symptoms, laboratory findings, response, and safety considerations.
I have had the opportunity to ask questions regarding treatment, potential benefits, risks, and alternatives, and I voluntarily consent to treatment when prescribed by my REVV Health provider.
I understand that some REVV Health appointments may be provided through telehealth, including video or telephone visits. I understand the potential limitations of telehealth and that my provider may recommend an in-person examination, additional testing, or referral when clinically appropriate.
I consent to receiving healthcare services through telehealth when appropriate.
I acknowledge that I have been provided access to REVV Health's Notice of Privacy Practices.
I understand that REVV Health may communicate with me regarding my care through the contact information I provide, including phone, voicemail, text message, email, and/or the patient portal, subject to applicable privacy and security practices.
