T3 Thyroid Treatment | Hypothyroidism | Bouc Family Wellness Clinic

As a new patient, please complete the terms agreement below. You need to complete the terms for ordering Labs, Supplements, and the T3 Subscription. For future visits, you will be able to go directly to the ordering page.

(If you are allergic to Pork containing products click here to obtain the terms agreement for compounded synthetic T3/T4 medication.)

Please click the box below to acknowledge your agreement and understanding of the following terms and conditions:

I am between the ages of 18 and 68

I am currently taking Synthroid/Levoxyl or Levothyroxine for treatment of hypothyroid condition.

I am not on Coumadin/Wafarin

I am not allergic to Armour thyroid or equivalent

I understand that all medication changes include the risk of fatal allergic reaction, unintended side effects and therapeutic failure.

I understand that risks specific to thyroid medication include worsening goiter, heart rhythm problems and palpitations and possible osteoporosis from long term overcorrection.

I understand that overcorrection with T3 containing medications may result in heart palpitations, increased insomnia, and anxiety.

I agree to stop medication and seek immediate medical care should any problems arise from my taking T3 containing medication.

I realize that I am undertaking empiric trail of T3 medication on an experimental basis for the treatment of symptoms associated with previously diagnosed under active thyroid.

I agree to obtain follow up labs per direction of Dr. Bouc.

I agree to email communication regarding lab results and medication changes.

Terms and agreements are as follows. Payment of $95 provides you with an annual prescription for Armour thyroid at appropriate dose as well as access to follow up labs and dose adjustment at appropriate intervals as deemed by Dr. Bouc. Labs are to be done at the nearest Quest lab near you. Labs and dose adjustment will be made at appropriate intervals until steady dose is achieved for up to one year. Dr. Bouc will not be responsible to respond to day to day questions regarding your thyroid or response to medication. If you are having problems with the change, then you are best served by seeing your primary medical doctor. This site is only to provide you with a prescription of T3 containing medication, in substitution for Levothyroxine, and is not intended to diagnose or treat your entire health status.

Click the button below to state you have read and agree to all terms of iwantmyt3.com.