Comprehensive Health Assessment & Treatment Consent Form
Document Version: 2025.1 | Effective Date: September 10, 2025
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.
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
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 including:
- Hormonal Health Markers (Testosterone, Estradiol, Thyroid Function)
- Metabolic Health Indicators (Glucose, Insulin, Lipid Panel)
- Nutritional Status Markers (Vitamins, Minerals, Essential Nutrients)
- Inflammatory Markers (CRP, ESR, Cytokine Panels)
- Cardiovascular Risk Factors (Advanced Lipid Analysis, Cardiac Markers)
- Liver and Kidney Function Markers
- Cancer Screening Markers (PSA, Tumor Markers as applicable)
I understand that biomarker results will be integrated into my Four-Engine Scoring System for comprehensive 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
This scoring system will generate personalized recommendations for optimization protocols and treatment plans.
By signing below, I acknowledge that:
- I have read and understand this consent form
- All my questions have been answered to my satisfaction
- I voluntarily consent to the assessments and treatments described
- I understand the risks, benefits, and alternatives
- I authorize ENNU Life to proceed with my comprehensive health evaluation and treatment
Patient Signature: Date:
Patient Name (Print):
Date of Birth:
Healthcare Provider Signature: Date:
Provider Name & Title:
License Number:
