Practice Documents

Documents | Forms | Patient Education

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AESTHETIC FORMS

Aesthetic Forms

Injectable Treatment Form LH1100

Injectable Treatment Form LH1100

Neuromodulators-Medical History LH1100

Neuromodulators-Medical History LH1100

Botox Consent Form LH1100

Botox Consent Form LH1100

CONSENT FORMS

All forms relating to Live Hearty Consents.

Consent Estradiol & Testosterone Implants-LH1100

Consent Estradiol & Testosterone Implants-LH1100

Consent for BIO IDENTICAL Hormone LH1100

Consent for BIO IDENTICAL Hormone LH1100

Consent Testosterone Pellet Implantation-LH1100

Consent Testosterone Pellet Implantation-LH1100

PATIENT CONSENT FORM FOR AI DICTATIONS-LH

PATIENT CONSENT FORM FOR AI DICTATIONS-LH

Peptide Informed Consent-LH1100

Peptide Informed Consent-LH1100

Testoserone Implant Consent LH1100

Testoserone Implant Consent LH1100

Testosterone Informed Consent LH1100

Testosterone Informed Consent LH1100

Weight Management Consent Semaglutide LH1100

Weight Management Consent Semaglutide LH1100

Weight Management Consent Tirzepatide LH1100

Weight Management Consent Tirzepatide LH1100

CREDT CARD AUTH FORMS / RECEIPTS

Credit Card authorization forms.

LH 1100 Medical Bill Receipt

LH 1100 Medical Bill Receipt

MEDICATION Pre-Order Credit Authorization LH1100

MEDICATION Pre-Order Credit Authorization LH1100

EMPLOYMENT

Live Hearty Employment documents

EMPLOYMENT-APPLICATION LH

EMPLOYMENT-APPLICATION LH

EMPLOYMENT DOCS LH

EMPLOYMENT DOCS LH

IV THERAPY

IV Therapy forms.

In-Office Infusion Form

In-Office Infusion Form

IV-Therapy-General-Release LH1100

IV-Therapy-General-Release LH1100

IV Therapy Selection LH1100.docx

IV Therapy Selection LH1100.docx

IV Therapy Triage Questionaire LH1100

IV Therapy Triage Questionaire LH1100

On Site Infusion Form v1.2 LH1100.docx

On Site Infusion Form v1.2 LH1100.docx

MEDICAL FORMS

All forms relating to patient visits including consents, drug tests, incident reports, and payments.

Aging Male Symptoms Scale-LH1100

Aging Male Symptoms Scale-LH1100

Androgen Deficiency Form-LH1100

Androgen Deficiency Form-LH1100

HRT discharge LH1100

HRT discharge LH1100

Medical-Records-Release-LH 1100

Medical-Records-Release-LH 1100

Menopause-Rating-Scale-LH1100

Menopause-Rating-Scale-LH1100

Standardized Assessment of Concussion LH1100

Standardized Assessment of Concussion LH1100

NEW PATIENT FORMS

Live Hearty New Patient forms.

HIPAA-Privacy-LH1100

HIPAA-Privacy-LH1100

HIPAA-Privacy-LH2030

HIPAA-Privacy-LH2030

LH 1100 Sign-in Sheet

LH 1100 Sign-in Sheet

LH_Integrative Wellness Interest

LH_Integrative Wellness Interest

LiveHearty-Packet-8-23-23

LiveHearty-Packet-8-23-23

ORDERS

Orders for Imaging, etc…

Imaging Order LH1100

Imaging Order LH1100

PATIENT EDUCATION

To be given to patient upon administration of corresponding vaccine.

After Pellet Insertion Instructions-LH1100

After Pellet Insertion Instructions-LH1100

After Pellet Insertion Instructions-LH2030

After Pellet Insertion Instructions-LH2030

Possible Temorary Side Effects-LH1100

Possible Temorary Side Effects-LH1100

Possible Temorary Side Effects-LH2030

Possible Temorary Side Effects-LH2030

Prostate Protetction-LH1100

Prostate Protetction-LH1100

Prostate Protetction-LH2030

Prostate Protetction-LH2030

Recommendations and precautions using Semaglutide or Tirzepatide LH1100

Recommendations and precautions using Semaglutide or Tirzepatide LH1100

Recommendations and precautions using Semaglutide or Tirzepatide LH2030

Recommendations and precautions using Semaglutide or Tirzepatide LH2030

Risks of Vitamin C-LH1100

Risks of Vitamin C-LH1100

Risks of Vitamin C-LH2030

Risks of Vitamin C-LH2030

Testosterone Implants Info – LH1100

Testosterone Implants Info – LH1100

Testosterone Implants Info – LH2030

Testosterone Implants Info – LH2030

PELLETS / PEPTIDES

Forms related to Hormone Pellets and Peptides.

Peptide Ratios and Mixdowns

Peptide Ratios and Mixdowns

Weight Loss & Peptides

Weight Loss & Peptides

Weight Loss & Peptides

Weight Loss & Peptides

WEIGHT MGMT

Weight Loss forms.

Retatrutide Dosing Instructions LH1100

Retatrutide Dosing Instructions LH1100

Semaglutide Attention LH1100

Semaglutide Attention LH1100

Semaglutide Dosing Instructions LH1100

Semaglutide Dosing Instructions LH1100

Semaglutide & Tirzepatide(subcutaneous) Injection Instructions LH1100

Semaglutide & Tirzepatide(subcutaneous) Injection Instructions LH1100

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