1. Informational & Educational Purpose

The intake review, consultations, and recommendations provided are for informational and educational purposes only and do not constitute medical advice, diagnosis, or prescription approval unless provided by a licensed provider.

2. Assumption of Risk & Informed Consent

I acknowledge that peptide therapy carries inherent risks including injection site reactions, headache, nausea, changes in blood sugar or hormonal levels, allergic reactions, and unknown adverse effects. Results are not guaranteed and may vary. I voluntarily assume all known and unknown risks.

3. Provider–Patient Relationship Notice

Submitting this form does not create a provider–patient relationship. Eligibility is determined at the sole discretion of the clinical team and submission does not guarantee acceptance.

4. Release of Liability & Waiver

To the fullest extent permitted by law, I release and hold harmless Pathway Peptides, its owners, staff, and affiliated providers from any claims arising from my participation in peptide therapy, adverse reactions, reliance on recommendations, or failure to disclose accurate health information.

5. Accuracy of Information

I certify that all information provided is true, accurate, and complete to the best of my knowledge. I agree to notify Pathway Peptides of any changes to my health status or medications.

6. Privacy & Confidentiality

My personal health information will be collected, stored, and used solely for evaluating eligibility and providing services, in accordance with applicable privacy laws.