INFORMED CONSENT FOR SEXUAL WELLNESS TREATMENTS AND MEDICATIONS

Including Compounded and Off-Label Prescriptions | Male and Female Sexual Health | Libido, Function, and Hormonal Optimization


Nationwide Applicability | California Compliant | Telehealth Enabled


PLEASE READ THIS DOCUMENT CAREFULLY


1. Overview of Sexual Wellness Treatment

You are being evaluated for a treatment plan designed to support sexual wellness and related concerns, which may include:
– Low libido or reduced sexual desire
– Erectile dysfunction (ED) or arousal issues
– Orgasmic dysfunction or performance concerns
– Hormonal imbalances related to sex hormones
– Age- or condition-related sexual decline


Treatments may involve prescription medications, lifestyle support, supplements, and compounded therapies customized to your needs.


2. Medications That May Be Prescribed

Your provider may recommend one or more of the following:
– Sildenafil, Tadalafil, or Vardenafil (oral ED medications)
– Oxytocin
– Testosterone (topical, injectable, or pellet)
– DHEA or estrogen modulators
– Bremelanotide (injectable peptide)
– PT-141 (compounded sexual arousal peptide)
– Arginine, yohimbine, or other compounded formulations


These medications may enhance desire, performance, lubrication, or erectile function depending on your symptoms and clinical evaluation.


3. Disclosure Regarding Compounded Medications

Some prescriptions may be compounded, meaning they are custom-formulated by licensed pharmacies to meet individual treatment needs.


Important information:

– Compounded medications are not approved or reviewed by the FDA.
– They are prepared under the guidance of your licensed healthcare provider.
– DrWell only partners with licensed U.S. compounding pharmacies.
– DrWell is LegitScript certified, which ensures lawful, transparent, and safe practices in telehealth and pharmacy operations.


4. Off-Label Use Disclosure

Some medications prescribed for sexual health may be used off-label—outside their primary FDA-approved indication. This is a common and legal medical practice based on clinical experience, peer-reviewed research, or evolving evidence in functional and sexual medicine.


Your provider will explain the purpose and intended benefits of any off-label treatment prescribed.


5. Potential Risks and Side Effects

All treatments may carry potential side effects, which may include:
– Headaches, flushing, or nasal congestion (ED meds)
– Blood pressure changes
– Nausea, dizziness, or fatigue
– Hormonal side effects (e.g., acne, mood changes, hair growth)
– Pain, irritation, or injection site discomfort (for injectables)
– Changes in sexual sensitivity or performance
– Allergic or adverse reactions


Your treatment will be monitored and adjusted as needed. Please report any unexpected side effects to your provider immediately.


6. No Guarantees or Promises

Sexual health treatments may enhance satisfaction, performance, or desire for some patients, but no specific result is guaranteed.


Outcomes depend on your age, baseline health, hormonal profile, mental wellness, lifestyle, and adherence to treatment.


7. Telehealth Services and Consent

Services may be delivered via telehealth, including video visits or asynchronous clinical assessments.


You understand and agree that:

– Your provider is licensed in the state where you are located during the consult.
– Your privacy is protected under HIPAA and telehealth privacy regulations.


California Residents (Business & Professions Code § 2290.5):

– You may withdraw consent to telehealth at any time.
– Your right to in-person care is preserved.


8. State Availability and Restrictions

While DrWell operates in all 50 states, access to certain medications—especially compounded sexual wellness therapies—may be restricted by state law or pharmacy licensing.


A complete consultation is required before prescribing any treatment, and availability is subject to local regulations and clinical appropriateness.


9. Patient Responsibilities

By participating in treatment, you agree to:
– Disclose your full sexual and medical history
– Follow dosing instructions exactly as provided
– Use medication responsibly and not share it
– Notify your provider of any new medications or side effects
– Abstain from using contraindicated substances (e.g., nitrates with ED meds)


Failure to comply may result in adverse effects or treatment termination.


10. Additional Support and Information

For questions about your sexual wellness treatment or medication, contact your provider directly or consult our safety page:

https://www.drwell.com/patient-resources

 

By proceeding with treatment, you acknowledge that you have read and understood this Informed Consent. You accept the risks and responsibilities outlined and consent to receive sexual wellness treatments and medications as prescribed by a licensed DrWell provider.