Online Consultation & Treatment Consent

Patient Consent for Online Consultation & Treatment Advice

I voluntarily request and consent to an online (telephonic / video / digital) consultation with DR HAIR CLINIC.

I understand and agree to the following:

1. Nature of Online Consultation

I understand that online consultation has inherent limitations, including lack of physical examination, and is based solely on:

Medical history provided by me
Photographs / videos uploaded by me
Information shared during consultation

2. Accuracy of Information

I confirm that all medical information, history, images, and details provided by me are true, complete, and accurate to the best of my knowledge.

I understand that incorrect, incomplete, or concealed information may affect diagnosis and treatment outcomes.

3. Treatment Outcomes

I understand that:

Hair and skin treatment results vary between individuals
No guarantee or assurance of cure, regrowth, or permanent results has been promised
Response to treatment depends on biological, genetic, hormonal, lifestyle, and medical factors

4. Medicines & Side Effects

I understand that prescribed medicines, supplements, or procedures may have possible side effects or limitations, which have been explained to me or are available in standard medical literature.

A. Oral Minoxidil Consent

I understand that oral minoxidil:

Is prescribed off-label for hair loss
May cause side effects such as:
Increased heart rate
Swelling of feet / face
Dizziness or headache
Low blood pressure
Excess body hair growth

I confirm that I do not have uncontrolled heart disease unless informed otherwise and agree to take it strictly as prescribed.

☑️ I consent to Oral Minoxidil if prescribed

B. Finasteride / Dutasteride Consent

I understand that finasteride / dutasteride:

Are hormone-modifying medicines
May cause reduced libido
Erectile dysfunction
Ejaculatory changes
Mood changes (rare)

I understand that:

These medicines are contraindicated in pregnancy
Female patients should not handle crushed tablets

☑️ I consent to Finasteride / Dutasteride if prescribed

5. Follow-Up & Compliance

I understand that treatment success depends on regular usage, follow-ups, lifestyle compliance, and adherence to medical advice.

6. Emergency & Physical Examination

I understand that online consultation is not suitable for medical emergencies and that I may be advised to seek in-person consultation or physical examination whenever required.

7. Refund & Legal Claims

I understand that consultation and treatment advice provided online does not automatically qualify for refund or compensation, unless explicitly covered under a written clinic policy.

8. Consent & Authorization

I hereby give my free, informed, and voluntary consent to receive online consultation and treatment advice from DR HAIR CLINIC and authorize the clinic to maintain my medical records digitally.

Menu