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Weight Loss Program Consent Form - bShopifyb 2025

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The document is a Weight Loss Program Consent Form in which the patient authorizes Dr. and their assistants to assist in weight reduction efforts. It outlines the components of the program, including diet, exercise, behavior modification, and potential use of appetite suppressants. The form details the risks associated with both the treatment and remaining overweight, emphasizing that success depends on the patient's efforts and that obesity may require lifelong management. The patient acknowledges understanding all aspects of the consent before signing.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the designated field at the top of the form. This identifies you as the patient authorizing the program.
Review the sections detailing the program components, including diet, exercise, and potential medications. Ensure you understand each aspect before proceeding.
Acknowledge your understanding of risks associated with both the program and remaining overweight by reading through these sections carefully.
If you have any questions or need clarification on any points, utilize our platform's comment feature to note them down for discussion with your doctor.
Once satisfied, fill in the date and time fields before signing. If applicable, include a witness signature in the designated area.

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