If you are experiencing chest pain, difficulty breathing, severe abdominal pain, signs of a severe allergic reaction, or any condition you believe may be dangerous, call 911 or go to the nearest emergency room now.
If you are having thoughts of harming yourself, call or text 988 to reach the Suicide & Crisis Lifeline.
Please read this consent carefully before your first consultation. By checking the consent box and typing your name at intake, you confirm that you have read and understood it and agree to receive care on these terms. You may request a copy at any time.
Who Is Treating You
Your medical care is provided by licensed clinicians practicing through OpenLoop Healthcare Partners, PC (the "Practice"), an independent professional entity. Your clinician is licensed in the state where you are located at the time of your visit.
Living Plus Rx LLC operates the platform you are using. It is a technology and administrative services company. It does not practice medicine, does not diagnose, does not prescribe, and cannot influence or override any clinical decision your clinician makes.
Your patient-clinician relationship is with the Practice. This consent is a consent to treatment by the Practice.
You may ask at any time for the name and license credentials of the clinician treating you.
What Telehealth Is
Telehealth means receiving medical care when you and your clinician are not in the same physical location. Care may be delivered through secure written messaging, questionnaires you complete on your own time (called asynchronous or store-and-forward care), telephone, or video.
Information exchanged may include your medical history, current symptoms, medications, allergies, weight and other measurements, photographs you upload, and laboratory results.
Benefits of Telehealth
Telehealth can make care more accessible — you can be evaluated without travel or time off work, often more quickly than an in-person appointment allows, and with a degree of privacy that some people prefer for weight-related care.
Risks and Limitations of Telehealth
You should understand the following before consenting:
- No physical examination. Your clinician cannot listen to your heart or lungs, palpate your abdomen, or perform any hands-on examination. Findings that an in-person visit would detect may be missed.
- Judgments rest on what you report. If the information you provide is incomplete or inaccurate, the clinical decision made from it may be wrong.
- Some conditions require in-person care. Your clinician may determine that telehealth is not appropriate for you and refer you elsewhere.
- Technology can fail. Transmission problems, poor image quality, or service interruptions may delay care or, rarely, result in loss of information.
- Electronic communication carries a small security risk despite encryption and safeguards.
- Delays are possible. Asynchronous care means your clinician responds within a period of time, not instantly. This service is not suitable for anything urgent.
What to Expect from Treatment
If your clinician determines that GLP-1 therapy is appropriate for you, treatment typically begins at a low dose and increases gradually over several weeks or months. This titration is deliberate — it reduces side effects and helps identify the lowest dose that works for you.
Weight loss is gradual and varies considerably between individuals. Some people lose little or no weight. These medications work alongside changes in diet and physical activity, not instead of them. If you stop treatment, weight regain is common.
You should not change your dose, take extra doses, or use medication left over from a previous prescription without speaking to your clinician first.
Risks and Side Effects of GLP-1 Medications
Semaglutide, tirzepatide, and related medications carry real risks. Read this section carefully and ask your clinician about anything that concerns you.
Common side effects. Nausea, vomiting, diarrhea, constipation, abdominal pain, heartburn, burping, reduced appetite, fatigue, headache, dizziness, and reactions at the injection site. These are most likely when starting treatment or increasing a dose, and often ease with time.
- Severe, persistent abdominal pain, especially pain radiating to your back, with or without vomiting — this may indicate pancreatitis.
- Pain in your upper right abdomen, fever, or yellowing of the skin or eyes — this may indicate gallbladder disease.
- A lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath — see Section 7.
- Swelling of the face, lips, tongue, or throat, or difficulty breathing — this may indicate a severe allergic reaction.
- Inability to keep fluids down, or signs of dehydration such as very dark urine, dizziness on standing, or passing little urine.
Serious risks you should know about.
- Pancreatitis. Inflammation of the pancreas has been reported. It is uncommon but can be life-threatening.
- Gallbladder disease. Gallstones and gallbladder inflammation occur more often with these medications, particularly with rapid weight loss.
- Dehydration and kidney injury. Persistent vomiting or diarrhea can cause dehydration severe enough to damage the kidneys. Maintain fluid intake and contact your clinician if you cannot.
- Low blood sugar. Risk is higher if you also take insulin or a sulfonylurea. Tell your clinician about every medication you take.
- Delayed stomach emptying. These medications slow digestion by design. In some people this becomes severe, causing persistent vomiting or, rarely, intestinal blockage.
- Vision changes. People with diabetic retinopathy may experience worsening as blood sugar improves rapidly. Report any change in vision.
- Loss of muscle as well as fat. Adequate protein intake and resistance exercise help preserve muscle during weight loss.
- Mood changes. If you notice new or worsening depression, anxiety, or any thoughts of harming yourself, contact your clinician immediately, and call or text 988 if you are in crisis.
This is not a complete list. Ask your clinician or pharmacist about any symptom that concerns you.
When These Medications Should Not Be Used
In animal studies, these medications caused thyroid C-cell tumors. It is not known whether they cause medullary thyroid carcinoma in humans.
Do not use these medications if you or any family member has had medullary thyroid carcinoma, or if you have Multiple Endocrine Neoplasia syndrome type 2. You must disclose this history at intake.
Tell your clinician before starting treatment if you have or have had: pancreatitis, gallbladder disease, kidney disease, severe gastrointestinal disease or gastroparesis, diabetic retinopathy, an eating disorder, or a previous allergic reaction to a GLP-1 medication.
Your clinician needs a complete list of your medications, supplements, and allergies. Some combinations meaningfully increase risk.
Surgery, Procedures, and Anesthesia
Because these medications slow stomach emptying, food may remain in your stomach far longer than expected — even after normal fasting. Under anesthesia or sedation this creates a risk of stomach contents entering the lungs, which can be life-threatening.
Before any surgery, endoscopy, colonoscopy, dental procedure with sedation, or imaging requiring sedation, tell the treating team you are taking a GLP-1 medication and follow their instructions on whether to pause it.
Pregnancy, Breastfeeding, and Contraception
These medications are not for use during pregnancy. If you are pregnant, think you may be pregnant, or are trying to become pregnant, do not start treatment and tell your clinician immediately. If you become pregnant during treatment, stop and contact your clinician.
If you are planning a pregnancy, discuss timing with your clinician well in advance — these medications are generally discontinued at least two months beforehand.
Do not use these medications while breastfeeding.
Oral contraceptives. Tirzepatide can reduce the absorption of birth control pills, particularly when starting treatment or increasing a dose. If you rely on oral contraception, discuss using an additional non-oral method with your clinician.
Weight loss itself can improve fertility, and pregnancy may occur more easily than you expect.
Compounded Medications
If your clinician prescribes a compounded medication, it is prepared by a state-licensed 503A pharmacy or an FDA-registered 503B outsourcing facility.
- Compounded medications are not FDA-approved. The FDA does not review them for safety, effectiveness, or manufacturing quality before they are dispensed.
- They may differ from commercially available products in concentration, inactive ingredients, and how they are administered.
- The dispensing pharmacy is responsible for compounding, quality control, labeling, and beyond-use dating.
- You are not required to use a partner pharmacy. You may ask that your prescription be sent to a pharmacy of your choosing, subject to that pharmacy's policies and applicable law.
Store your medication as instructed, and do not use it past its beyond-use date.
Monitoring and Follow-Up
Your clinician may ask you to complete follow-up check-ins, report your weight, or obtain laboratory testing before starting treatment or before a dose increase. These requests exist for your safety, and your clinician may decline to continue treatment if they go unanswered.
Tell your clinician promptly about any side effect, any new medication prescribed by another provider, and any change in your health.
This service does not replace a primary care physician. You should maintain a relationship with one, and we encourage you to tell them about this treatment so your care is coordinated.
Your Responsibilities
- Provide truthful, complete information about your medical history, medications, supplements, and allergies.
- Use your real legal identity, and do not seek treatment on behalf of anyone else.
- Be physically located in the state you have told us you are in during your visit.
- Follow your clinician's instructions on dosing, storage, and administration.
- Never share your medication with anyone else. Doing so is unlawful and can seriously harm them.
- Keep your account information secure.
Withholding relevant medical information can lead to serious harm. Your clinician may discontinue treatment if information you provided proves inaccurate.
Electronic Communications
You consent to receive communications by secure portal message, email, telephone, SMS, and push notification. Clinical communication takes place through secure messaging.
Standard email and text messages are not encrypted end-to-end. We limit them to appointment, refill, shipping, and account messages and do not send detailed clinical information through them. You may ask us to contact you only in a specific way.
Your Health Information
Your medical record is created and held by the Practice. How it may be used and disclosed, and the rights you have over it, are described in the Notice of Privacy Practices. Living Plus Rx handles account, billing, and platform information as described in its Privacy Policy.
Information necessary to fill your prescription is shared with the dispensing pharmacy.
Costs
All services are self-pay. Insurance, including Medicare and Medicaid, is not billed and these services are generally not reimbursable. You are responsible for the full cost. Pricing and billing terms are described in the Terms of Service.
Paying for a consultation does not guarantee that a prescription will be issued.
Your Rights
- Withdraw this consent at any time, without affecting care you have already received.
- Refuse or stop treatment at any time. Talk to your clinician first where possible, particularly about stopping suddenly.
- Request in-person care instead of telehealth, and receive a referral.
- Ask questions and receive answers you understand before agreeing to treatment.
- Access your medical record, as described in the Notice of Privacy Practices.
- Choose your pharmacy.
- Seek a second opinion at any time.
- Receive a copy of this consent.
No Guarantee of Outcome
No clinician can promise a particular result. Telehealth may not resolve your condition, treatment may not work for you, and your clinician may decline to prescribe if they judge treatment inappropriate. Results described by other patients are their individual experiences and are not a prediction of yours.
Reporting Side Effects
Report any side effect to your clinician through secure messaging. For anything severe or worsening quickly, seek emergency care first and tell us afterward.
You may also report side effects directly to the FDA through MedWatch at fda.gov/medwatch or by calling 1-800-FDA-1088. Reporting helps identify problems that trials do not detect.
Acknowledgment and Consent
- You have read and understood this document, and had the opportunity to ask questions.
- You understand the risks and limitations of telehealth described in Section 4.
- You understand the risks of GLP-1 medications described in Sections 6 through 9, including the thyroid cancer warning and the anesthesia risk.
- You understand that compounded medications are not FDA-approved.
- You understand that no outcome is guaranteed and that no prescription is guaranteed.
- The information you have provided about your health is truthful and complete.
- You are at least 18 years old and located in the state you have identified.
- You consent to receive telehealth services from clinicians practicing through OpenLoop Healthcare Partners, PC
Questions about this consent can be directed to support@livingplusrx.com, or to your clinician through secure messaging. Clinical questions should always go to your clinician.
Medical services are provided by licensed clinicians practicing through OpenLoop Healthcare Partners, PC Living Plus Rx LLC is a technology and administrative services company and does not practice medicine. Compounded medications are not FDA-approved. This document is not a substitute for the conversation with your clinician — ask about anything you do not understand before consenting.