ENCLOMIPHENE MONTHLY MEMBERSHIP

PRICING:

• $250 per month

MEMBERSHIP INCLUDES:

• Physician initial visit fee
• Physician follow up visit fee (at 8 weeks, 16 weeks)
• Initial labs (1)
• Follow-up labs (at 8 weeks, 16 weeks)
• Enclomiphene prescription monthly
• Re-order convenience
• Shipping fees

DETAILS:

• $250 is automatically charged to the card on file every month until canceled
• 6 month minimum requirement for the membership program
• Product cannot be return or refunded
• Initial and follow up labs include full metabolic panel

1. Introduction

This consent form is to inform you about the use of enclomiphene for the treatment of hypogonadism and to increase testosterone levels. Enclomiphene is not approved by the U.S. Food and Drug Administration (FDA) for this indication, and its use in this context is considered off-label.

2. Purpose of Treatment

The purpose of this treatment is to address symptoms associated with hypogonadism, such as low testosterone levels, and to potentially improve related clinical conditions.

3. Nature of the Procedure

Enclomiphene is administered orally. The dosage and treatment schedule will be determined based on your specific medical condition and response to treatment.

4. Potential Benefits

The expected benefits of enclomiphene treatment include an increase in testosterone levels and improvement in symptoms of hypogonadism. 

5. Possible Risks and Side Effects

Like all medications, enclomiphene can cause side effects. These may include, but are not limited to, mood changes, vision disturbances, and other estrogen-related effects. The long-term risks are not fully understood due to the lack of FDA approval for this use.

6. Alternatives

Alternative treatments, including FDA-approved therapies for hypogonadism, lifestyle modifications, and other interventions, have been considered and discussed.

7. Voluntary Participation

Your decision to undergo this treatment is voluntary. You have the right to refuse or discontinue treatment at any time.

8. Questions and Information

You have the opportunity to ask questions about the treatment, and your questions have been answered to your satisfaction.

9. Consent

By signing this form, you acknowledge that you have read and understood the information provided, the risks and benefits of enclomiphene treatment, and consent to proceed with the treatment under the guidance of your physician.

I agree to the Terms of Service, Privacy Policy, Consent to Treat, and Cancellation Policy.

1. Introduction

This consent form is to inform you about the use of enclomiphene for the treatment of hypogonadism and to increase testosterone levels. Enclomiphene is not approved by the U.S. Food and Drug Administration (FDA) for this indication, and its use in this context is considered off-label.

2. Purpose of Treatment

The purpose of this treatment is to address symptoms associated with hypogonadism, such as low testosterone levels, and to potentially improve related clinical conditions.

3. Nature of the Procedure

Enclomiphene is administered orally. The dosage and treatment schedule will be determined based on your specific medical condition and response to treatment.

4. Potential Benefits

The expected benefits of enclomiphene treatment include an increase in testosterone levels and improvement in symptoms of hypogonadism. 

5. Possible Risks and Side Effects

Like all medications, enclomiphene can cause side effects. These may include, but are not limited to, mood changes, vision disturbances, and other estrogen-related effects. The long-term risks are not fully understood due to the lack of FDA approval for this use.

6. Alternatives

Alternative treatments, including FDA-approved therapies for hypogonadism, lifestyle modifications, and other interventions, have been considered and discussed.

7. Voluntary Participation

Your decision to undergo this treatment is voluntary. You have the right to refuse or discontinue treatment at any time.

8. Questions and Information

You have the opportunity to ask questions about the treatment, and your questions have been answered to your satisfaction.

9. Consent

By signing this form, you acknowledge that you have read and understood the information provided, the risks and benefits of enclomiphene treatment, and consent to proceed with the treatment under the guidance of your physician.

I agree to the Terms of Service, Privacy Policy, Consent to Treat, and Cancellation Policy.

1. Introduction

This consent form is to inform you about the use of enclomiphene for the treatment of hypogonadism and to increase testosterone levels. Enclomiphene is not approved by the U.S. Food and Drug Administration (FDA) for this indication, and its use in this context is considered off-label.

2. Purpose of Treatment

The purpose of this treatment is to address symptoms associated with hypogonadism, such as low testosterone levels, and to potentially improve related clinical conditions.

3. Nature of the Procedure

Enclomiphene is administered orally. The dosage and treatment schedule will be determined based on your specific medical condition and response to treatment.

4. Potential Benefits

The expected benefits of enclomiphene treatment include an increase in testosterone levels and improvement in symptoms of hypogonadism. 

5. Possible Risks and Side Effects

Like all medications, enclomiphene can cause side effects. These may include, but are not limited to, mood changes, vision disturbances, and other estrogen-related effects. The long-term risks are not fully understood due to the lack of FDA approval for this use.

6. Alternatives

Alternative treatments, including FDA-approved therapies for hypogonadism, lifestyle modifications, and other interventions, have been considered and discussed.

7. Voluntary Participation

Your decision to undergo this treatment is voluntary. You have the right to refuse or discontinue treatment at any time.

8. Questions and Information

You have the opportunity to ask questions about the treatment, and your questions have been answered to your satisfaction.

9. Consent

By signing this form, you acknowledge that you have read and understood the information provided, the risks and benefits of enclomiphene treatment, and consent to proceed with the treatment under the guidance of your physician.