Reset Wellness, PLLC policies
Reset Wellness, PLLC Clinical Policies PATIENT CONSENT FOR WEIGHT LOSS THERAPY AND TREATMENT WITH RESet WELLNESS, PLLC
If you have any questions, please feel free to ask us. Please sign to acknowledge your understanding:
If you are late or miss your appointment, you may be subject to a $50 fee. Rescheduling appointments is offered one time free of charge. After that, Reset Wellness, PLLC reserves the right to charge for your visit 24 hours before the visit is scheduled to occur.
Services must be paid for before the time of service.
While we do not require any commitment, our providers do recommend you stick with the program for at least 3 months to see the results you are looking for! Oftentimes, significant loss will happen with higher doses and that can’t be achieved before 3 months. We are here to make this a success for you.
Please also note that we do not automatically ship medication without a visit. Medication is ordered during visits when requested and needed.
Health insurance typically does not cover services provided at Reset Wellness, PLLC. If you want to seek insurance reimbursement, we would be happy to provide you itemized invoices that you can submit to your insurance company.
I agree that I will take my medications as prescribed. I agree to follow my medical provider’s instructions. I also agree that I will not sell or share my prescriptions to other individuals.
I understand that treatments used at Reset Wellness, PLLC might not be considered a medical necessity. Treatments rendered are for the purpose of improving your quality of life through hormone restoration, nutritional, and supplemental counseling, and weight loss or weight maintenance treatment.
I agree that if I am having any side effects or become sick, that I will follow up with my primary care provider or go to an urgent care or emergency department immediately.
I acknowledge that Restorative Wellness, PLLC and our providers are not my primary care provider. I agree that I will continue with routine care through my primary care provider and notify them of treatments prescribed at Reset Wellness, PLLC
I understand that having an appointment with Reset Wellness, PLLC does not necessarily entitle me to being issued a prescription for hormone replacement, weight loss medication, or additional medications. Every individual is different, and it is at the medical provider’s discretion to issue a prescription. If you are not prescribed a medication, the $50 initial visit fee is waived.
I do not hold any medical practitioner of Reset Wellness, PLLC responsible for performing age-related preventive care. I agree that I will follow up with my primary care provider to obtain these screenings and I hold all providers of Reset Wellness, PLLC harmless if an adverse event occurs during my treatment. I will ensure that my primary care provider provides the results of such screenings to Restorative Wellness, PLLC as this could change the treatment prescribed to me.
I agree to indemnify, defend, protect, and hold harmless the medical providers or staff employed or contracted by Reset Wellness, PLLC and their respective officers, directors, employees, stockholders, assigns, successors and affiliates (Indemnified Parties) 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, the medical providers employed by Reset Wellness, PLLC rendering medical care, services, advice, and/or treatment, my failure to disclose all relevant information regarding my medical and physical condition, acts or omissions, the medical providers employed or contracted by Reset Wellness, PLLC ; harm or injury resulting from medical care or pharmaceuticals provided directly or indirectly by the medical providers employed by Reset Wellness, PLLC. I am aware of the potential side effects associated with weight loss therapy, accept all the risks involved in taking the medication and will not seek indemnification or damages from the indemnified parties.
