Vida Wellness

Peptide Consultation Form

Personal Information

Medical History

Peptide Information

Liability Waiver and Consent:
I, the undersigned, hereby acknowledge that I am aware that the use of peptides involves potential risks and side effects. I understand that the information provided in this consultation form is for evaluation purposes only and does not constitute medical advice or treatment recommendations. I voluntarily choose to use peptides, and I assume full responsibility for any adverse effects that may result from their use. I hereby release and discharge the healthcare provider and their affiliates, employees, and representatives from any liability, claims, demands, or actions arising out of or related to the use of peptides.