VEYRA Health Telehealth Consent & Agreement

1. Telehealth Consent. I consent to receive healthcare services via telehealth technology, including video consultations, messaging, and remote monitoring. I understand these services are provided by licensed healthcare providers.

2. Treatment Acknowledgment. I understand that GLP-1 receptor agonist medications (including tirzepatide and retatrutide) are being prescribed based on my health profile. I understand these medications may have side effects and that results vary by individual.

3. No Guarantee. VEYRA Health and its providers do not guarantee specific weight loss results. Individual results depend on medication response, diet, exercise, and adherence to the program.

4. Information Accuracy. I confirm that all information provided during registration, health assessment, and screening is true and accurate to the best of my knowledge.

5. Medical Discretion. I understand that the medical team may decline to prescribe medication if they determine it is not in my best interest. The program recommendation provided is preliminary and subject to provider review.

6. Photo Consent. I consent to the use of my progress photos for tracking my treatment progress. Photos will be stored securely and will not be shared without my additional written consent.

7. Privacy & HIPAA. I understand my health information is protected under HIPAA and will be handled in accordance with applicable privacy laws.

8. Payment Terms. I understand that payment is required for my program. If I choose monthly payments, my card will be automatically charged on the same date each month. If I choose lump sum, the full amount is charged at enrollment.

9. Cancellation. I may cancel future shipments with 14 days notice. Refunds are subject to the cancellation policy in effect at time of purchase.

10. Liability Waiver. I release VEYRA Health, its providers, staff, and affiliates from any liability arising from my use of the program, except in cases of gross negligence or willful misconduct. I acknowledge I have been advised to consult my primary care physician before starting any weight loss program.

11. Partner Disclosure. If I was referred by a partner, I understand they may receive a commission at no additional cost to me.

By checking the box and signing below, I acknowledge that I have read, understood, and agree to all terms above.