Medical Consent

Consent to Consultation and Assessment/Report including Nutritional Supplements Recommendations.

I authorize David Epstein, D.O. and such physicians (SOP Doctor), associates, assistants and other personnel of the Second Opinion Physician chosen by him or her to perform the following: Hormonal Assessment and Supplements Recommendation.

I understand that that Second Opinion Physician PC, and SOP Doctor offers a set of diagnostic tests plus an Assessment with Supplements plan. When Consultation and or Assessment is ordered, SOP Doctor is provides these results and recommendations for the purpose of supporting me in seeking specialized protocols such as those taught by William Walsh PhD of the Walsh Institute and by Dr Mark Gordon MD of Millennial Health Care to help me address PTSD and or various mood disorders. I have sought assistance with SOP Doctors because the protocols offered here are not feasibly available to me by my local or primary care practitioners.

I also understand that Second Opinion Physician or my SOP Doctor may encourage me to choose my preferred professional quality brand, either locally or online from reputable suppliers. BiotypeNutrients.com is a website developed as a resource to physicians and their patients for locating top brands with ingredients and dosages that are aligned according to the protocols offered for by SOP Doctor and other practitioners specializing in these protocols. Biotype Nutrients is owned by Second Opinion Physician P.C. and the products are sold at the MAP -Manufacturers Advertised Rate. David Epstein is the owner of Second Opinion Physician, PC.

SECOND (or THIRD) OPINION: I have been encouraged to seek another ‘second opinion’ concerning the proposed treatment from physicians trained by the Walsh Institute, Millenial or from qualified physicians of my choosing.

LIMITATIONS OF MEDICAL CARE: In all cases, SOP Doctor is providing a service that is focused on assessing lab reports and factoring in use of other medications and history of trauma and characteristics of mood disorder. SOP Doctor and Second Opinion Physician are not responsible for acute or urgent care situations or form my ongoing general health care. SOP Doctor does not write prescriptions nor make changes to my medications plan.

I have been advised that this information may be shared with my personal physician for primary care management, should that be requested by myself. It is important to continue with ongoing care from my physician to take into consideration my overall health profile, including and a face to face evaluation, medications use, ongoing issues and vital signs testing. My primary care doctor shall continue to provide any and all prescriptions as well as plan for discontinuing any medications should that become an option per my condition and discussion with trusted primary physician. I hereby authorize the doctor to speak directly with my Primary Care physician when medically necessary regarding my past and present medical care and treatment.

Furthermore, If I am located in the states of California, New York and New Jersey, SOP Doctors and lab tests are not available to me due to state medical board restrictions.

Very important – If I become pregnant, or am currently pregnant, these supplements may be harmful to my developing child. Only abstinence from the supplements or consultation with my primary provider or OB-GYN can reasonably address these issues. If discontinuation of supplements during pregnancy leads to difficult emotional issues, this issue must be taken up with my primary care provider including OB-GYN and psychiatrist.

 

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