Terms and Conditions

Orchid Weight Loss Clinical Policies

PATIENT CONSENT FOR WEIGHT LOSS THERAPY AND TREATMENT WITH ORCHID WEIGHT LOSS, LLC

If you have any questions, please feel free to ask.

• If you are late or miss your appointment, you may be subject to a $50 fee.
• Services must be paid for at the time of service. 
• Health insurance typically does not cover services provided at Orchid Weight Loss, LLC. If you want to seek insurance reimbursement, we would be happy to provide you itemized invoices that you can submit to your insurance company. 
• I understand that treatments used at Orchid Weight Loss, LLC might not be considered medically necessary. Treatments rendered are for the purpose of improving your quality of life through nutritional and supplemental counseling, and weight loss treatment. 
• I agree that if I am having any side effects or become sick, that I will follow up with my primary care provider or go to an urgent care or emergency department. 
• I acknowledge that Orchid Weight Loss, LLC and Julie Robinson APRN-CNP are not my primary care provider. I agree that I will continue to receive routine care through my primary care provider and notify them of treatments prescribed at Orchid Weight Loss, LLC. 
• I understand that there are no refunds for services or products rendered. We cannot accept used medications once they have been dispensed per state regulation.
• I understand that having an appointment with Orchid Weight Loss, LLC does not necessarily entitle me to being issued a prescription for weight loss medication or additional medications. Every individual is different, and it is at the medical providers discretion to issue a prescription.
• I understand that I must maintain my follow up appointments to continue treatment. It is important that lab work is monitored regularly for safety purposes. It is important that Orchid Weight Loss, LLC manages my treatment.
• I acknowledge that I have been advised of the risks and benefits of treatment. I also acknowledge that I have been advised of possible complications and side effects. I understand the risks, benefits, complications, and side effects of treatment. 
• I am voluntarily requesting treatment with Orchid Weight Loss, LLC and Julie Robinson APRN-CNP for medically managed weight loss therapy as determined by a mutual decision between myself and the medical provider.
• I do not hold any medical practitioner of Orchid Weight Loss, LLC responsible for performing age-related preventive care. I agree that I will follow up with my primary care provider to obtain these screenings and I hold Orchid Weight Loss, LLC and Julie Robinson APRN-CNP harmless if an adverse event occurs during my treatment. I will ensure that my primary care provider provides the results of such screenings to Orchid Weight Loss, LLC as this could change the treatment prescribed to me.

* A copy of above clinics polices will be provided upon initial consult.