Get me started

Congratulations on starting on the Edman Clinic Ongoing Weight Loss Program. 

Please review the structure of the program and read the consent form below. After then, submit your information and you will be contacted soon.


Consent Form

 

1. I agree to receive non-secure communications from Edman Clinic and its staff.  I am aware that:

  • Email/text can be circulated, forwarded and stored electronically and on paper.

  • Email/text can be immediately broadcast worldwide and be received by unintended recipients.

  • Email/text senders can easily misaddress an email.

  • Backup copies of Email/text may exist even after the sender or the recipient has deleted his or her copy.

  • Employers and on-line services have a right to archive and inspect email/text transmitted through their systems.

  • Email/text can be intercepted, altered, forwarded, or used without authorization or detection.

  • Email/text can be used to introduce viruses into computer systems.

  • Email/text may be used as evidence in court.

2. I agree to the program rules.

3. I understand that the program may not be ideal due to its lack of one-on-one meetings and that I may not lose as much as weight as I would with a program that has one-on-one meetings.

4. I agree to never share my medications.

5. I will contact Dr Edman immediately if I have any side effects that I believe are related to the medication or weight loss

6. I agree to document my weight at least four times a month.

7. I understand that I can terminate at any time and that no refunds will be available once a script is issued.

8. I understand that Dr Edman can terminate my participation in the program at any time.

 

Please submit the following form to join program and agree to the Consent Form and Program Rules.

Join the Edman Weight Loss Program

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By clicking the "Join the Program" button below, I confirm that I have read and agree to the Program Rules and Consent Form.