PATIENT ACKNOWLEDGMENTS
Important understandings before care.
Effective August 24, 2026
These acknowledgments are intended for the clinical intake process, not the general marketing form. The treating provider and dispensing pharmacy may require additional product-specific documents.
Independent clinical judgment
I understand that Nuveena is a technology and administrative platform. My clinician is an independent licensed provider who alone determines whether evaluation, treatment, or prescribing is appropriate. My pharmacy independently determines whether and how to dispense a valid prescription.
No guaranteed prescription or result
I understand that payment, enrollment, or completion of a questionnaire does not guarantee treatment, a prescription, fulfillment, availability, absorption, or a particular outcome.
Accuracy and disclosure
I agree to provide complete and accurate health, medication, allergy, pregnancy, and identity information to the provider and pharmacy, and to promptly disclose changes. I understand incomplete information may increase risk.
Medication and compounded-product acknowledgment
- I will use a prescribed product only as directed by my provider and pharmacy and will not share or resell it.
- I understand a compounded product is prepared for an identified patient pursuant to a valid prescription and is not FDA-approved in the same manner as a commercially approved drug.
- I understand compounded or investigational ingredients may have limited safety, efficacy, stability, interaction, or route-of-administration data.
- I will review pharmacy labeling and product-specific instructions and contact the provider or pharmacy with questions.
Risks and adverse events
I understand that known and unknown adverse effects, allergic reactions, drug interactions, treatment failure, or worsening symptoms may occur. I will seek emergency help for severe symptoms and report suspected adverse events to the provider and pharmacy.
Communication and privacy
I understand ordinary email and text messages may not be fully secure and should not contain sensitive medical details. Clinical communications should use the provider's designated secure channel.
No waiver of protected rights
These acknowledgments document understanding and consent; they do not waive rights that cannot legally be waived, excuse professional negligence, or limit the duties of a licensed provider or pharmacy.