Patient Consent Agreement

1 · Consent to Medical Treatment

I consent to receive medical evaluation and treatment from licensed clinicians of MKH Medical, PLLC (the "Practice").

(1) Who provides my care. Medical care is provided only by the Practice's licensed clinicians. Coaching, nutrition, training, and administrative services are provided separately by HOLLYWORLD LLC d/b/a HollyFit, which does not practice medicine, provide medical advice, or direct medical care.

(2) Nature of care. My care may include health-history review, laboratory testing and review, clinical consultations, diagnosis, treatment planning, and - only if my clinician independently determines it is medically appropriate - prescription medications.

(3) No guarantee. No outcome is guaranteed. Payment never guarantees a prescription or any particular treatment.

(4) My responsibilities. I agree to provide accurate and complete health information, including medications, allergies, and conditions, and to update the Practice when they change.

(5) Right to refuse or withdraw. I may decline any recommended treatment and withdraw this consent at any time in writing, subject to my clinician's guidance on safely discontinuing active treatment.

(6) Emergencies. The Practice does not provide emergency care. In an emergency I will call 911.

(7) Privacy. My health information is handled per the Notice of Privacy Practices, made available to me.

2 · Financial Policy & Payment Authorization

(1) What I am purchasing. HollyFit memberships are coaching and support services. Fees also cover, per my tier, physician consultations and lab review by MKH Medical, PLLC, and - only if a clinician prescribes treatment - the cost of covered medications. No tier includes, promises, or guarantees any medication.

(2) Billing. I authorize recurring charges to my card on file, processed by the payment processor of record. My tier fee is first billed on day 14 after signup or at my initial consultation, whichever is sooner, and on my tier's recurring schedule thereafter.

(3) Optional bloodwork. I may purchase an optional at-home lab kit (currently $149) at signup; this charge is separate from the tier fee.

(4) Insurance. Services are not billed to insurance; reimbursement is not guaranteed.

(5) Cancellation & refunds. I may cancel in-app or by email to von@hollyfitllc.com; cancellation is effective at the end of the current billing cycle with no partial refunds; access continues through the paid cycle; the $149 lab kit is non-refundable once shipped; dispensed or shipped medication remains subject to the pharmacy's terms and law.

(6) Failed payments. If a recurring payment is declined, I will receive notice where practicable and services may be suspended if unresolved.

(7) Price changes. Fees may change with advance notice, applied only after the notice period, never retroactively.

3 · Prescription & Compounded Medication Consent

(1) Clinical judgment only. Medications are prescribed only when my clinician independently determines treatment is medically appropriate. Payment never guarantees a prescription.

(2) Compounded medications. Some medications may be compounded by a state-licensed pharmacy to my clinician's specifications and are not FDA-approved as compounded products. Compounded semaglutide and tirzepatide are not interchangeable with FDA-approved brands (Wegovy, Ozempic, Zepbound, Mounjaro).

(3) Dispensing. Prescriptions, if issued, are dispensed by Believe Rx or Partell (Partell is represented as LegitScript-certified) or another lawful pharmacy, shipped only where lawful; the dispensing pharmacy may change.

(4) Risks, benefits, alternatives. My clinician will discuss risks, benefits, side effects, and alternatives (including no medication). I agree to report side effects promptly and complete any monitoring labs required.

(5) Off-label & regulatory status. Some medications, including compounded and peptide-based therapies, may be prescribed off-label or without FDA-approved labeling - a lawful part of medical practice in the clinician's independent judgment. My clinician will tell me when a treatment is off-label or investigational; I may ask questions or decline.

(6) Transfer of care. If I transfer from another provider, continuation of existing treatment occurs only after records review and my clinician's independent evaluation.

(7) Storage & disposal. I am responsible for storing medication as directed, away from others (especially children), and disposing of unused medication safely per instructions and law.

(8) Controlled substances. If a controlled substance such as testosterone is prescribed, the Controlled-Substance terms below also apply.

(9) Monitoring. Continued therapy may depend on follow-up visits, lab monitoring, and adherence to instructions.

4 · Controlled-Substance Addendum

(1) Controlled substances are prescribed only if the clinician independently determines they are appropriate. Payment never guarantees a prescription.

(2) Testosterone is a controlled substance. If prescribed, it may be Schedule III and dispensed by a licensed pharmacy such as Partell, or another lawful pharmacy.

(3) Electronic prescribing. Controlled-substance prescriptions may be transmitted only through EPCS-compliant systems and only when permitted by law.

(4) Prescription monitoring. The clinician may review my history through the state prescription drug monitoring program as required or permitted by law.

(5) Identity verification. I agree to complete any identity verification required before a controlled substance is prescribed or dispensed.

(6) Refills. Early refills are not provided; refills are per the clinician's judgment, applicable law, and the prescription schedule. Lost, stolen, or damaged medication may not be replaced.

(7) State-specific requirements. Any additional requirements in my state are set out in an attached state rider.

(8) Compliance. I agree to use the medication only as prescribed, not to share or transfer it, and to store and dispose of it safely.