Purpose:
I understand that I am being prescribed peptide therapy to support and optimize physiological functions such as hormone regulation, tissue repair, immune modulation, and/or metabolic function.
Description of Treatment:
Peptide therapy may include compounds such as: BPC-157, CJC, Sermorelin, Ipamorelin, Tesamorelin, Bremelanotide, IGF, Semaglutide, MK-677.
I understand that peptides are administered by injection, oral, sublingual, or nasal routes, depending on the specific compound.
Potential Benefits:
Possible side effects may include:
Consent:
I understand that peptide therapies are not FDA approved for all uses and are considered investigational/ off label in most cases.
I have read and understand the information provided. I have had the opportunity to ask questions, and all questions have been answered to my satisfaction. I consent to receive peptide therapy and assume full responsibility for any risks associated and will not hold Echelon Integrative Health, Dr. Iannotti, Chelsey Dobesh NP, or staff to any and all possible scenarios and consequences. I agree to follow the prescribed dosing schedule, report any side effects promptly, and attend follow-up visits or labs as directed.
All Peptide Injections must be Purchased prior to ordering. Allow 2 weeks for compounding. Amounts vary.
Please sign your name in the area below