ENNU LIFE MEDICAL PRACTICE

Comprehensive Health Assessment & Treatment Consent Form

Document Version: 2025.1 | Effective Date: September 10, 2025

1. PATIENT INFORMATION & CONSENT ACKNOWLEDGMENT

I, ________________________________ (Patient Name), understand that I am consenting to comprehensive health assessments and evidence-based treatment protocols offered by ENNU Life Medical Practice. This consent covers all assessments, biomarker analysis, treatment recommendations, and follow-up care.

2. COMPREHENSIVE HEALTH ASSESSMENT AUTHORIZATION

I authorize ENNU Life Medical Practice to conduct the following assessments as part of my comprehensive health evaluation:

• Welcome Health Assessment: Baseline health evaluation and goal establishment
• Hormone Assessment: Comprehensive endocrine system evaluation
• Weight Loss Assessment: Metabolic health and body composition analysis
• Testosterone Assessment: Male hormone optimization evaluation (if applicable)
• Hair Assessment: Aesthetic health and DHT correlation analysis
• Skin Assessment: Dermatological health and aging evaluation
• Peptide Therapy Assessment: Therapeutic peptide protocol evaluation
• Nutrition Assessment: Comprehensive dietary and metabolic evaluation
• Sleep Assessment: Sleep quality and optimization analysis
• Stress Assessment: Psychological and physiological stress evaluation
• Fitness Assessment: Physical performance and exercise capacity
• Aesthetic Assessment: Beauty optimization and aesthetic health

3. BIOMARKER ANALYSIS & LABORATORY TESTING

I consent to biomarker analysis including but not limited to the processing of laboratory results from LabCorp and other certified laboratories. This includes analysis of 100+ biomarkers across multiple health categories.

4. FOUR-ENGINE SCORING SYSTEM & HEALTH OPTIMIZATION

I understand that ENNU Life utilizes a proprietary Four-Engine Scoring System that evaluates my health across four primary pillars:

• Body Pillar (35% weight): Physical health, biomarkers, and physiological function
• Mind Pillar (25% weight): Cognitive function, mental health, and psychological well-being
• Social Pillar (25% weight): Social connections, relationships, and community engagement
• Aesthetics Pillar (15% weight): Physical appearance, beauty optimization, and aesthetic health

5. PRIVACY, CONFIDENTIALITY & HIPAA COMPLIANCE

I understand that all my health information will be protected in accordance with HIPAA regulations and applicable privacy laws.

PATIENT ACKNOWLEDGMENT & SIGNATURE

By signing below, I acknowledge that I have read and understand this consent form and voluntarily consent to the assessments and treatments described.

Patient Signature: ______________________ Date: __________

Patient Name (Print): ______________________

Healthcare Provider Signature: ______________________ Date: __________

Provider Name & Title: ______________________