I hereby certify that the foregoing history is true and complete to the best of my knowledge and I have read the Retatrutide Information on KMM's website, have had an opportunity to ask questions that were answered to my satisfaction, and do wish to receive the Retatrutide fully understanding the risks and the benefits. I hereby consent to the administration of the Retatrutide. Furthermore, I hereby release and forever discharge for myself, my heirs, executors, administrators and assignees, KMM—Kaiser Medical Management and their employees, owners and representatives, contract workers and any/all health providers involved with providing this service, as well as the company sponsoring this clinic and their agents, representatives, employees, successors, assignees, governing bodies, and advisory committees from any and all claims, demands, actions and causes of action, which may result from participation in this clinical trial program. I will not seek to be reimbursed by Medicare, Medicaid, Tricare or any other insurer/payer for this clinical trial program and understand it is an out-of-pocket expense that I am 100% responsible for. Your personal information and results shall be held strictly confidential. I understand KMM-Kaiser Medical Management is not a Medicare participating provider. Insurance/Medicare will not be billed. For all safety reasons, KMM holds the right to refuse service with or without explanation. My submission on this site is my understanding, compliance, consent, and agreement to receiving Retatrutide. I UNDERSTAND I CANNOT BE NOR WILL I BE ON ANY OTHER WEIGHT LOSS PROGRAM SUCH AS OZEMPIC, MOUNJARO, SEMAGLUTIDE, TIRZEPATIDE TO NAME OF A FEW BUT NOT LIMITED. I UNDERSTAND RE-ORDERS MUST BE DONE A MINIMUM OF 2 WEEKS PRIOR. I UNDERSTAND MY SUBMISSION IS MY SIGNATURE, MY UNDERSTANDING OF ALL PROTOCOL IN REGARD TO RETATRUTIDE, MY WAIVER OF MY RIGHTS TO ANY/ALL LEGAL AND/OR ACTIONS TOWARDS KMM AND AFFILIATES. FOR RESEARCH PURPOSES ONLY.