What is it?
The Consent Form for GLP-1s is a legally required document to obtain patient consent before prescribing semaglutide or tirzepatide.
Note: This Consent Form covers BOTH semaglutide and tirzepatide.
It must be signed by the patient before a GLP-1 is prescribed. (Note: You'll use this Form in addition to your regular Informed Consent/Consent to Treat Form.)
It covers areas like:
- descriptions of both semaglutide and tirzepatide.
- potential risks + benefits of both types of GLP-1s.
- voluntarily consent to receive GLP-1s.
Who needs it?
All licensed medical practitioners working with patients who have prescription privileges for BHRT including:
- Physicians (all types), including Integrative, Functional and Lifestyle Physicians
- Nurse practitioners
- Physician assistants
- All licensed medical practitioners working in patient relationships who are allowed to prescribe BHRT under their scopes of practice.
Legal Love™ Tip:
- Use this form when prescribing GLP-1s under your scope of practice.
- Use this form if you’re using your medical title like “Dr.”, “Nurse Practitioner” or “PA” and working with patients in states where you’re licensed.
Note: This is NOT the correct form if you’re a “coach” under any circumstance. It’s not to be used by medical practitioners who are not authorized to prescribe GLP-1s.
Client Love
Why do you need it?
This Consent Form for GLP-1s helps you:
- Get written consent for GLP-1s specifically —before services begin.
- Ensure clear communication with patients in writing.
- Share the benefits and risks with professionalism and ease.
- Be energetically aligned in your sacral chakra by creating clear boundaries + expectations.
This form reduces risk for both you and your patients—building trust through transparency.
What’s included in the DIY package?
- Informed Consent Form Template
- Easy-to-edit doc.
- Fill in the blank format you can use right away.
- Plain English - no confusing legalese.
- Created with care + Legal Love™.
How does it work?
- Receive an email from us with instructions.
- Download your DIY template.
- Fill in the blanks.
- Save your changes (don’t skip this step!)
- Share it with your patients—electronically or in person - and keep a signed copy.
What's the investment?
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