Peptide Therapy Consent
The risks, benefits, and regulatory status of compounded peptide therapy.
What I am agreeing to
I am choosing to receive peptide therapy prescribed by Jason D. Wright, D.O., through a telehealth evaluation. My medications are prepared for me individually by a licensed 503A compounding pharmacy and shipped to me directly.
Compounded medications
- Compounded medications are not FDA-approved. The FDA has not reviewed them for safety, effectiveness, or quality, and they do not carry FDA-approved labeling.
- A compounded medication is not the same as a brand-name product, even when it contains the same active ingredient.
- Strength, purity, and stability depend on the compounding pharmacy rather than a manufacturer’s quality program.
Off-label and limited evidence
- Most peptides prescribed here are used off-label, meaning for a purpose the FDA has not approved.
- For many of them, the human evidence is limited to small studies, animal research, or clinical experience. Long-term safety data does not exist for most.
- No result is promised or guaranteed. Individual responses vary, and some patients notice no benefit.
Telehealth
- I understand my care is provided remotely and that a physical examination is not performed.
- I must be physically located in Washington, Idaho, Montana, Utah, Arizona, Ohio, or Illinois at the time of each visit.
- This service is not for emergencies. In an emergency I will call 911 or go to the nearest emergency room.
- I agree to give accurate and complete health information, including all medications, supplements, and medical conditions.
General risks of injectable peptide therapy
- Injection-site reactions: redness, itching, swelling, bruising, or a small lump.
- Injection-site infection, which is uncommon but possible.
- Allergic reaction, including rare severe reaction requiring emergency care.
- Headache, nausea, flushing, fatigue, or changes in sleep.
- Unknown long-term effects.
My responsibilities
- I will follow the dosing instructions I am given and will not change my dose on my own.
- I will store and use my medication as instructed, and will dispose of needles in a sharps container.
- I will complete the follow-up visits and any lab work my physician orders.
- I will report side effects promptly, and will not share my medication with anyone.
Pregnancy, fertility, and athletics
- I will tell my physician if I am pregnant, breastfeeding, or planning pregnancy. Most of these medications are not used in those situations.
- If I am a competitive athlete, I understand many of these peptides are prohibited by the World Anti-Doping Agency and can cause a positive drug test.
Financial
- Love My Peptides is self-pay. Insurance is not billed and no claim is submitted on my behalf.
- Visit fees, medication prices, and shipping are explained to me in advance and are subject to the practice’s refund and cancellation policy.
- Compounded medication prepared specifically for me cannot be returned or refunded once dispensed.
My right to stop
I may stop treatment at any time. I understand that stopping may reverse any benefit I have gained, and that I should tell the practice so my plan can be adjusted safely.
Product-specific addenda (GLP-1 medications, Melanotan II, IGF-1 LR3, ibutamoren and the ghrelin-receptor blends, methylene blue, hCG, enclomiphene and clomiphene, kisspeptin, PT-141, and the TB-500 blends) are reviewed and signed with your physician for the specific products you are prescribed.