Informed Consent
LeanRx Program — Zenvra Health and Wellness LLP
Version 1.0 | Effective May 2026
This document contains two consent forms:
- Part A — Assessment Consent (to be accepted before completing the LeanRx eligibility assessment)
- Part B — Program Consent (to be accepted before the first paid consultation and program commencement)
Please read both parts carefully. If you have questions, contact us at hello@resonatehealth.in or +91 94670 02444 before proceeding.
PART A — Assessment Consent
A1. Purpose of the Assessment
The LeanRx eligibility assessment is a structured questionnaire designed to determine whether the LeanRx program is appropriate for your current health profile. The assessment takes approximately 15 minutes to complete.
The assessment is not a medical examination and does not constitute a clinical diagnosis. It is a screening tool used by our care coordination team to determine program suitability.
A2. Information We Collect
During the assessment, we collect the following categories of information:
- Personal details: name, age, gender, contact information
- Health history: existing medical conditions, previous diagnoses, current medications
- Weight and body composition history: previous weight loss attempts, current BMI range
- Lifestyle information: diet patterns, physical activity, sleep
- Goals: target outcomes and timeline
This information is stored securely and accessed only by authorised members of your care team. It is never shared with advertisers or sold to third parties.
A3. Hard-Stop Conditions
Certain medical conditions make participation in the LeanRx program unsafe or contraindicated. If any of the following apply to you, you will be automatically directed to seek advice from your own physician rather than proceeding with LeanRx:
- Personal or family history of medullary thyroid carcinoma (MTC)
- Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- Current pregnancy or breastfeeding
- Severe gastrointestinal conditions (e.g. gastroparesis)
- Type 1 diabetes
- Recent pancreatitis or history of chronic pancreatitis
- Severe renal or hepatic impairment
- Active eating disorder
This list is not exhaustive. The supervising physician will conduct a full clinical review before any medication is considered.
A4. What Happens After the Assessment
After you submit the assessment:
- Our care coordination team reviews your responses within 2 business days
- If you appear eligible, you will be contacted to schedule a paid consultation with our supervising physician
- If you are not eligible, you will be informed and, where appropriate, directed to alternative resources
Completion of the assessment does not guarantee enrolment in the program. Final eligibility is confirmed by the supervising physician at the consultation stage.
A5. Assessment Consent Declaration
By submitting the LeanRx eligibility assessment, I confirm that:
- I am 18 years of age or older
- The information I have provided is accurate and complete to the best of my knowledge
- I understand the assessment is a screening tool and not a medical consultation
- I consent to Zenvra Health and Wellness LLP storing and using my assessment data to evaluate my eligibility for LeanRx and to contact me regarding the program
- I have read and agree to the Resonate Health Privacy Policy and Terms of Service
PART B — Program Consent
This consent is obtained before your first paid consultation. It must be signed before any program services are delivered.
B1. Nature of the LeanRx Program
LeanRx is a GLP-1 weight loss support program operated by Zenvra Health and Wellness LLP through the Resonate Health platform. The program provides:
- A structured care coordination protocol involving a supervising physician, nutritionist, and fitness expert
- Weekly body composition tracking via BCA scans
- Longitudinal health data recording (biomarkers, nutrition, fitness, body composition)
- Bi-weekly coaching check-ins
- Monthly physician review
- Blood work interpretation and contextualisation
The program does not include medication. Medication is prescribed separately by the supervising physician if clinically appropriate and is subject to a separate cost. You may purchase medication through our pharmacy partner or independently.
B2. GLP-1 Medication — What You Should Know
GLP-1 receptor agonists (such as semaglutide and tirzepatide) are prescription medications. I understand the following:
- GLP-1 medication can only be prescribed by a licensed physician. The LeanRx program does not itself prescribe medication — this is done exclusively by the supervising physician following clinical assessment.
- GLP-1 medications carry potential side effects including but not limited to: nausea, vomiting, diarrhoea, constipation, fatigue, injection site reactions, and in rare cases, more serious adverse events.
- The physician will discuss specific risks with me before any prescription is issued.
- I am not obligated to take GLP-1 medication. The program's coordination and tracking services are available regardless of whether medication is prescribed.
- If I experience side effects, I will contact the care team and/or my physician immediately.
B3. Risks and Limitations
I understand and acknowledge the following:
- Individual results vary. The LeanRx program does not guarantee specific weight loss outcomes.
- The program is not a substitute for emergency medical care. In a medical emergency I will call 112 immediately.
- The effectiveness of the program depends on my engagement, honesty, and adherence to recommended protocols.
- If I do not attend scheduled consultations or check-ins without notice, my care team's ability to support me is limited.
- The program is not appropriate for all individuals and may be discontinued by the supervising physician if it is determined to be unsafe for me.
B4. My Responsibilities
By enrolling in LeanRx, I agree to:
- Provide complete and accurate health information at all times, including disclosure of all medications, supplements, and health conditions
- Attend or reschedule consultations and check-ins with at least 24 hours notice where possible
- Report any adverse reactions, new symptoms, or significant health changes to the care team promptly
- Not share my platform access credentials with any other person
- Treat all members of the care team with respect
B5. Data and Confidentiality
I consent to the following:
- My health and program data will be accessible to all members of my LeanRx care team (supervising physician, nutritionist, fitness expert, and care coordinator)
- My data may be used in anonymised, aggregated form for program improvement and outcome reporting — never in a way that identifies me individually without my explicit consent
- I may request access to, correction of, or deletion of my data at any time by contacting hello@resonatehealth.in
- Medical records will be retained for the period required by applicable Indian law
B6. Fees and Cancellation
I confirm that I have read and understood the fee structure and cancellation policy as set out in the Terms of Service, including:
- Program fees are payable in advance for the chosen plan (monthly, 3-month, or 6-month)
- No refund is issued once the first consultation or program session has been delivered
- Cancellation before the first consultation: full refund within 48 hours of written request
- Cancellation due to medical ineligibility identified by the care team: full refund within 7 business days
B7. Voluntary Participation
My participation in the LeanRx program is entirely voluntary. I am free to withdraw at any time by providing written notice to hello@resonatehealth.in. Withdrawal does not entitle me to a refund for services already delivered.
B8. Program Consent Declaration
By proceeding with payment and enrolment in the LeanRx program, I confirm that:
- I have read and understood this Informed Consent document in full
- I have had the opportunity to ask questions and have received satisfactory answers
- I voluntarily consent to enrol in the LeanRx program under the terms described above
- I understand the nature, risks, and limitations of GLP-1 support programs
- I am 18 years of age or older and legally capable of entering into this agreement
- I agree to the Terms of Service and Privacy Policy of Resonate Health / Zenvra Health and Wellness LLP
Signature Block
For in-person or paper-based consent. For digital consent, acceptance is recorded at the point of form submission or payment.
Patient Full Name: _________________________________________________
Date of Birth: _________________________________________________
Signature: _________________________________________________
Date: _________________________________________________
Contact Number: _________________________________________________
For Care Team Use Only
Supervising Physician Name: _________________________________________________
Physician Signature: _________________________________________________
Date of Review: _________________________________________________
Zenvra Health and Wellness LLP | hello@resonatehealth.in | +91 94670 02444 | resonatehealth.in