Informed Consent for Medical Services
Last Updated: August 2025
Note: This online version is for informational purposes. You will be asked to complete a consent form at your appointment.
Patient Information and Consent
This informed consent form provides important information about DEXA (Dual-Energy X-ray Absorptiometry) scanning and telehealth services at Desert Dexa Inc. Please read this information carefully and ask any questions you may have before agreeing to receive our services.
Services Offered
DEXA Scanning Services
DEXA scanning is a non-invasive diagnostic tool that uses low-dose X-ray technology to measure:
- Body composition (body fat percentage, lean muscle mass, fat distribution)
- Bone mineral density
- Visceral adipose tissue (fat around internal organs)
- Regional body composition (arms, legs, trunk)
Telehealth Weight Management Services
Our telehealth platform connects you with licensed healthcare providers for:
- Medical consultations via video/audio conferencing
- Weight management program evaluation and planning
- Medication prescriptions and monitoring
- Ongoing medical support and follow-up care
- Laboratory monitoring and medication adjustments
Description of Procedures
DEXA Scanning Procedure
During a DEXA scan:
- You will lie on a padded table for approximately 10-15 minutes
- A scanning arm will pass over your body without touching you
- You must remain still during the scan to ensure accurate results
- The procedure is painless and non-invasive
- No injections or medications are required
Telehealth Consultation Procedure
During a telehealth consultation:
- You will connect via secure video conferencing technology
- Your healthcare provider will review your medical history and current health status
- You may be asked to take progress photos or measurements
- Lab work may be ordered for monitoring purposes
- Medications may be prescribed based on your individual needs
- Follow-up appointments will be scheduled as medically appropriate
- Sessions may be recorded for quality assurance with your consent
Risks and Benefits
DEXA Scanning Benefits:
- Accurate measurement of body composition and bone density
- Early detection of osteoporosis risk
- Tracking of fitness and health progress
- Identification of muscle imbalances
- Assessment of visceral fat levels
DEXA Scanning Risks:
- Minimal radiation exposure from low-dose X-ray technology
- No known side effects from the procedure
- Potential for claustrophobia in sensitive individuals (though the machine is open)
Telehealth Services Benefits:
- Convenient access to licensed healthcare providers
- Evidence-based medical treatment
- Potential for significant health improvements with prescribed medications
- Ongoing medical monitoring and support
- Reduced risk of health-related conditions
⚠️ CRITICAL MEDICATION RISKS
Important Safety Information
Certain medications may cause serious side effects including thyroid tumors. These medications are contraindicated in patients with specific medical conditions. Your healthcare provider will review all contraindications and risk factors before prescribing any medication.
Most Serious Risks Include:
- Thyroid tumors/cancer: May cause lump in neck, hoarseness, trouble swallowing, shortness of breath
- Pancreatitis: Severe stomach pain that may spread to your back, with or without vomiting
- Gallbladder problems: Upper stomach pain, fever, yellowing of skin or eyes
- Kidney problems: Especially in patients with existing kidney disease
- Severe allergic reactions: Swelling of face, lips, tongue or throat, difficulty breathing
- Low blood sugar: Especially when used with diabetes medications
Common Side Effects:
- Nausea, vomiting, diarrhea
- Constipation, stomach pain
- Headache, fatigue, dizziness
- Injection site reactions
- Decreased appetite
Telehealth Technology Risks:
- Technology failures may disrupt consultations
- Internet connectivity issues may affect session quality
- Limited physical examination capabilities compared to in-person visits
- Potential privacy concerns with video conferencing (mitigated by HIPAA-compliant platforms)
Contraindications
DEXA Scanning Contraindications
You should NOT have a DEXA scan if you:
- Are pregnant or may be pregnant
- Have had a contrast dye study (barium or iodine) within 7 days
- Have had a nuclear medicine scan within 7 days
- Weigh more than 450 pounds (equipment limit)
- Are unable to lie still for the duration of the scan
Medication Contraindications
You should NOT use certain medications if you have:
- Personal or family history of medullary thyroid carcinoma (MTC)
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Type 1 diabetes
- Severe gastroparesis
- History of pancreatitis
- Are pregnant, planning to become pregnant, or breastfeeding
- Allergy to prescribed medications or any medication components
- Severe kidney disease
- History of severe gastrointestinal disease
Telehealth Service Limitations
Telehealth may not be appropriate if you:
- Require immediate emergency medical attention
- Have unstable medical conditions requiring in-person monitoring
- Are unable to use technology or communicate effectively via video
- Do not have reliable internet access
- Are located in Alaska, Mississippi, or New Jersey (where we do not currently offer telehealth services)
Confidentiality
All information obtained during your DEXA scan will be kept confidential in accordance with our Privacy Policy and Notice of Privacy Practices. Your results will not be shared with anyone without your written authorization, except as required by law.
Right to Refuse or Withdraw
You have the right to:
- Refuse the DEXA scan at any time
- Ask questions before, during, or after the procedure
- Request a copy of your results
- Withdraw consent at any time before the scan begins
Financial Consent
I understand that:
- Desert Dexa does not accept insurance
- Payment is due at the time of service
- I am responsible for the full cost of the scan
- Cancellations must be made 24 hours in advance for a full refund
Medical Disclaimer
Important: DEXA scan results provided by Desert Dexa are for informational purposes only. Desert Dexa staff are not medical doctors and cannot provide medical diagnoses or treatment recommendations. You should discuss your results with a qualified healthcare provider before making any changes to your health, fitness, or medical treatment plans.
Comprehensive Consent Statements
DEXA Scanning Consent
By receiving a DEXA scan at Desert Dexa, I acknowledge and agree that:
- I have read and understood the information provided about DEXA scanning
- I have had the opportunity to ask questions, and my questions have been answered to my satisfaction
- I understand the benefits and risks of the DEXA procedure
- I confirm that I do not have any DEXA scanning contraindications
- I understand that the results are for informational purposes only and do not constitute medical advice
- I voluntarily consent to undergo a DEXA scan
- I authorize Desert Dexa to perform the DEXA scan
Telehealth Services Consent
By using Desert Dexa's telehealth platform, I acknowledge and agree that:
- I understand the limitations of telehealth compared to in-person medical care
- I consent to receiving medical care through video/audio technology
- I understand that technology failures may disrupt consultations
- I consent to my medical information being shared with licensed healthcare providers on the platform
- I understand that telehealth sessions may be recorded for quality assurance purposes
- I consent to the collection and use of my health data as described in the Privacy Policy
- I will provide accurate and complete medical history information
- I understand that I am responsible for finding appropriate emergency care if needed
Medication Consent
By accepting a prescription for medications, I acknowledge and agree that:
- I have read and understand the BLACK BOX WARNING about thyroid tumors
- I understand the serious risks including pancreatitis, gallbladder problems, and kidney issues
- I confirm that I do not have any contraindications to prescribed medications
- I will immediately report any concerning symptoms to my healthcare provider
- I understand that treatment results may vary and are not guaranteed
- I commit to attending all required follow-up appointments and lab work
- I will adhere to the prescribed medication regimen and lifestyle modifications
- I understand that I must stop the medication if I become pregnant
- I consent to ongoing monitoring of my treatment progress and side effects
- I understand the importance of proper injection technique and storage
Photography and Recording Consent
Additional consent options will be discussed during your visit as applicable:
- Taking progress photos for medical documentation and tracking
- Recording of telehealth sessions for quality assurance
- Use of de-identified data for research and quality improvement
- Sharing medical information with pharmacy partners for prescription fulfillment
Financial and General Consent
I acknowledge and agree that:
- I understand all financial obligations associated with these services
- Desert Dexa does not accept insurance for any services
- Payment is due at the time of service or prior to telehealth consultations
- Medication costs are separate from consultation fees
- I understand cancellation policies for all services
- I may withdraw my consent at any time before procedures begin
- I have received copies of relevant privacy policies and safety information
- All my questions have been answered to my satisfaction
Special Considerations for Minors
For patients under 18 years of age:
- A parent or legal guardian must provide written consent
- The parent or guardian must be present during the scan
- The minor should also provide verbal assent when appropriate
Photography and Data Use
I understand that:
- My scan data will be stored securely for comparison with future scans
- Anonymous, aggregated data may be used for quality improvement
- No identifying information will be shared without my explicit consent
Emergency Contact Information
In the unlikely event of a medical emergency during your scan, we will contact emergency services and your designated emergency contact.
Questions and Contact Information
If you have questions about this consent form or the DEXA scanning procedure, please contact:
Desert Dexa Inc.
69848 Highway 111 Suite 7
Rancho Mirage, CA 92270
Phone: (760) 301-6806
Email: contact@desertdexa.com
Consent Acknowledgment
A completed consent form will be required before your DEXA scan. By scheduling an appointment and receiving services, you acknowledge that you have read, understood, and agree to the terms outlined in this consent form.