Testosterone Replacement Therapy Consent

TELEHEALTH INFORMED CONSENT

Effective Date: January 21, 2026

IMPORTANT NOTICE – NOT FOR EMERGENCIES
THE TRTBOSS PLATFORM IS NOT DESIGNED FOR EMERGENCY OR URGENT MEDICAL CARE. IF YOU BELIEVE YOU ARE EXPERIENCING A MEDICAL EMERGENCY, CALL 911 OR GO TO THE NEAREST EMERGENCY DEPARTMENT IMMEDIATELY.

This Informed Consent (“Consent”) describes the terms under which you may receive a telehealth evaluation and, if clinically appropriate, treatment related to Testosterone Replacement Therapy (“TRT”).

Please read this document carefully. TRT is a prescription medical treatment that carries material risks, requires ongoing monitoring, and is subject to state and federal controlled-substance laws.

1. Scope and Purpose

This Consent applies to telehealth medical services related to the evaluation, initiation, and management of testosterone deficiency and related symptoms.

It explains:

The nature and limitations of telehealth TRT care

Potential risks, side effects, and uncertainties of TRT

Monitoring and compliance requirements

Patient responsibilities and consent acknowledgments

This Consent addresses clinical consent only.
Pricing, subscriptions, billing, cancellations, and refunds are governed by separate commercial terms.

2. Parties and Corporate Practice of Medicine Disclosure

Medical care is provided by independent, licensed healthcare professionals (“Clinicians”) practicing through independent professional medical entities.

VALKORA LLC, doing business as TRTBOSS (“TRTBOSS”), is a non-clinical technology company and management services organization that:

Provides technology, administrative, and coordination services

Does not practice medicine

Does not diagnose, treat, or prescribe

Does not control or influence clinical judgment

All medical decisions are made solely by your treating Clinician, in accordance with professional standards and applicable law.

3. Telehealth Modality and Consent

Your evaluation and care may be delivered through:

Video visits

Secure messaging

Audio-only encounters

Asynchronous questionnaires

Transmission of laboratory results and health information

You acknowledge that:

Your Clinician is not physically present with you

A physical examination may not be possible

Telehealth may limit diagnostic accuracy in some cases

You affirmatively consent to receive TRT-related care via telehealth and understand that telehealth may not be appropriate for all patients or conditions.

4. Clinical Evaluation and No Guarantee of Treatment

Completion of intake forms, laboratory testing, telehealth consultations, or payment does not guarantee that:

TRT will be prescribed

TRT will be continued

TRT will be effective for you

TRT is prescribed only when a Clinician determines, in their independent medical judgment, that treatment is:

Clinically appropriate

Medically necessary

Permitted under applicable state and federal law

5. Description of Testosterone Replacement Therapy

If prescribed, TRT may involve administration of testosterone through one or more formulations, including:

Injectable preparations

Topical gels or creams

Oral formulations

Implantable pellets

The formulation, dosage, route of administration, and duration of therapy are determined solely by your Clinician and may change over time.

6. Potential Risks, Side Effects, and Uncertainties

You acknowledge that TRT involves known and potential risks, which may vary by individual and formulation. These may include, but are not limited to:

Increased red blood cell count (erythrocytosis or polycythemia), increasing the risk of blood clots, stroke, or cardiovascular events

Changes in blood pressure or cholesterol

Acne, oily skin, hair loss, or fluid retention

Breast tenderness or enlargement (gynecomastia)

Mood changes, irritability, anxiety, sleep disturbances, or changes in libido

Worsening of obstructive sleep apnea

Testicular shrinkage, reduced sperm production, and impaired fertility, which may be prolonged or not fully reversible

Changes in prostate-related symptoms or prostate-specific antigen (PSA) levels

Liver enzyme abnormalities (risk varies by formulation)

Administration-related risks such as injection-site pain, bleeding, infection, or dosing errors

For topical products, accidental transfer to others through skin contact

You understand that long-term risks of TRT, including cardiovascular outcomes, are the subject of ongoing scientific study and are not fully known.

7. Fertility and Reproductive Considerations

You acknowledge that TRT can suppress natural testosterone production and sperm development.

TRT may not be appropriate if you are actively trying to conceive.
You are responsible for discussing fertility goals with your Clinician before and during treatment.

8. Monitoring, Laboratory Testing, and Safety Requirements

If TRT is prescribed, ongoing monitoring is mandatory.

Monitoring may include periodic laboratory testing such as:

Testosterone levels

Hematocrit / red blood cell count

PSA

Lipids

Liver enzymes

Monitoring is typically required at regular intervals (often approximately every 90 days initially), but frequency may change based on clinical judgment.

Compliance Requirement

Failure to complete required monitoring, laboratory testing, or follow-up evaluations may result in:

Delay or denial of prescription refills

Dose modification

Temporary suspension of therapy

Mandatory discontinuation of TRT

9. Controlled Substance and Legal Compliance

Testosterone is classified as a controlled substance under federal law.

By consenting, you acknowledge and agree that:

TRT must be used only as prescribed

You will not share, transfer, or misuse testosterone

You will store medication securely

You will report loss or theft promptly

Misuse, diversion, or non-compliance with legal or clinical requirements may result in immediate discontinuation of care.

You further acknowledge that:

Telehealth prescribing laws may change

In-person evaluation may be required in some circumstances

Prescribing is contingent on ongoing compliance with state and federal law

10. Pharmacies and Dispensing

If a prescription is issued:

Medications are dispensed by independent third-party pharmacies

TRTBOSS does not own or operate pharmacies

Pharmacy availability, fulfillment, and delivery are subject to law and pharmacy policies

11. Patient Responsibilities

You agree to:

Provide accurate, complete, and truthful medical information

Disclose all medications, supplements, and relevant health history

Report side effects or adverse events promptly

Comply with monitoring, follow-up, and safety requirements

Follow Clinician instructions

Failure to meet these responsibilities may result in denial or discontinuation of care.

12. Voluntary Consent and Right to Withdraw

Participation in TRT is voluntary.

You may withdraw consent and discontinue treatment at any time by notifying your care team or discontinuing services. Withdrawal of consent will result in discontinuation of TRT.

13. Acknowledgment and Affirmative Consent

By proceeding, you acknowledge that:

You have read and understand this TRT Informed Consent

You had the opportunity to ask questions and receive answers

You understand the risks, uncertainties, and alternatives

You understand TRT involves a controlled substance

You voluntarily consent to telehealth evaluation and, if clinically appropriate, TRT as determined by your Clinician

14. Changes to This Consent

This Consent may be updated from time to time.
The version in effect at the time of your evaluation governs.

15. Contact Information

For questions regarding TRT services:

TRTBOSS Team
contact@trtboss.com