Practice
Navara Health, PLLC
5301 Alpha Road, Suite 34, Room 21
Dallas, Texas 75240
Contact
469-653-3124
contact@navarahealthtx.com
Treating Provider
Jessica Boggs, MSN, APRN, FNP-C, ENP-C
Medical Director
Simal Patel, MD
Purpose of This Consent
This consent describes the framework under which Navara Health, PLLC recommends nutraceutical supplements as part of my care, the regulatory status of these products, known and potential interaction risks, and the financial disclosure regarding the Navara Health Fullscript dispensary. This document applies to all supplement recommendations made during my care unless I revoke it in writing.
Two-Part Documentation. This master consent covers the general framework for supplement recommendations. When a specific supplement protocol is recommended for me, I will also receive (and where requested, sign) a per-recommendation acknowledgment documenting the specific products, doses, and clinical rationale (Section 11). Together, the two documents form the complete consent record.
Regulatory & FDA Disclosure (DSHEA)
Under the Federal Food, Drug, and Cosmetic Act and the Dietary Supplement Health and Education Act of 1994 (DSHEA), vitamins, minerals, trace elements, amino acids, herbs, botanicals, nutraceuticals, and homeopathic remedies are not classified as drugs and are not FDA-approved to diagnose, treat, cure, or prevent any disease.
I understand and acknowledge:
- Supplements are regulated as a separate category from prescription medications
- FDA pre-market safety and efficacy review does not apply to dietary supplements
- Statements made about supplements (including statements made by Navara Health) have not been evaluated by the FDA
- However, these substances may:
- Have significant physiological effects
- Influence metabolic, hormonal, immune, neurological, and inflammatory pathways
- Produce both beneficial and adverse effects
- Interact with medications, other supplements, and disease states
Purpose of Supplement Recommendations
Supplement recommendations at Navara Health are personalized and made in the context of my overall care plan, which may include:
- Hormone optimization (estrogen, progesterone, testosterone, thyroid, DHEA, pregnenolone)
- Metabolic or weight management programs (including GLP-1 therapy)
- Gut, immune, or inflammatory support
- Performance, recovery, sleep, and longevity goals
- Cognitive support and stress modulation
- Adjunctive support for aesthetic and skin health protocols
- Nutrient repletion based on lab findings
I understand that supplements are intended to support normal physiological function and are not a replacement for primary care, specialty medical care, prescription medications, or emergency treatment.
Interactions, Side Effects & Disclosure Requirements
Supplements may interact with prescription medications, other supplements, and disease states in clinically meaningful ways. Common high-risk interactions I should be aware of include, but are not limited to:
Anticoagulants & Antiplatelets
Increased bleeding risk: fish oil/omega-3, garlic, ginkgo biloba, ginger, turmeric/curcumin (high dose), vitamin E (high dose), nattokinase, and serrapeptase may increase bleeding when combined with warfarin, apixaban, rivaroxaban, dabigatran, aspirin, or clopidogrel.
Antidepressants & Psychiatric Medications
Serotonin syndrome risk: St. John's Wort, SAMe, 5-HTP, L-tryptophan, and rhodiola may interact with SSRIs, SNRIs, MAOIs, and other serotonergic medications. St. John's Wort also affects metabolism of many medications via CYP3A4 induction.
Thyroid Medications
Calcium, iron, magnesium, and biotin may interfere with absorption of levothyroxine. Take thyroid medication at least 4 hours apart from these. Biotin can also distort certain lab tests including thyroid panels — discontinue 72 hours before lab draws.
Blood Pressure & Cardiac Medications
Licorice root may cause potassium loss and hypertension. Hawthorn, CoQ10, and L-arginine may augment blood pressure medication effects. Grapefruit (in any form) interacts with statins, calcium channel blockers, and many other drugs.
Diabetes & GLP-1 Medications
Berberine, chromium, alpha-lipoic acid, gymnema, and bitter melon may have additive hypoglycemic effects with metformin, sulfonylureas, insulin, or GLP-1 medications. Patients on GLP-1 therapy should disclose all supplements due to delayed gastric emptying which may alter supplement absorption and timing.
Hormone Therapies
DIM, calcium-D-glucarate, and certain phytoestrogens may modulate estrogen metabolism. Maca, ashwagandha, and adaptogens may affect cortisol and thyroid balance. Phytoestrogens may interfere with hormone-sensitive conditions. Discuss any supplement changes if you are on BHRT, TRT, or other hormone therapy.
Sedatives & Sleep Aids
Melatonin, valerian, kava, magnolia, GABA, and certain herbs may potentiate sedative medications and alcohol. Kava has additional liver toxicity warnings.
Lab Interference
Biotin (high dose) interferes with many immunoassay-based lab tests including thyroid, troponin, hCG, and hormone panels. Discontinue biotin at least 72 hours before labs. High-dose vitamin C may affect glucose meter readings.
This list is not exhaustive. Potential interactions may not be fully known or documented for all supplement-medication combinations. I agree to:
- Disclose all medications, supplements, hormones, peptides, and therapies I am using at every visit
- Notify Navara Health of any changes to my medication or supplement regimen
- Report any adverse reactions or unexpected symptoms promptly
- Consult with my pharmacist when starting any new supplement, particularly if I take prescription medications
Failure to disclose this information may increase the risk of adverse effects.
Pre-Procedure & Pre-Surgery Supplement Hold
Critical Pre-Procedure Safety
Supplements That May Need To Be Held Before Surgery, Anesthesia, or Invasive Procedures
Many supplements affect bleeding, platelet function, anesthesia metabolism, or cardiovascular response. Before any surgery, dental procedure with sedation, endoscopy, colonoscopy, aesthetic injection procedure, microneedling, or other invasive procedure, I will inform my surgeon, dentist, or anesthesiologist of all supplements I am taking. Common supplements that may need to be held 7–14 days before procedures include:
- Bleeding-risk supplements (typically hold 7–14 days): fish oil / omega-3, garlic, ginkgo biloba, ginger (high dose), turmeric/curcumin, vitamin E (high dose), willow bark, feverfew, dong quai, nattokinase, serrapeptase, bromelain
- Sedation interaction supplements (hold 5–7 days): kava, valerian, St. John's Wort, melatonin (high dose)
- Cardiovascular-effect supplements (case-by-case): ephedra, ma huang, high-dose caffeine extracts, licorice root, yohimbe
- GLP-1 + supplement combinations: if I am on GLP-1 therapy, hold instructions from my GLP-1 provider take precedence for both the medication and concurrent supplements
I will not stop supplements pre-procedure without provider guidance if I am taking them for a specific clinical reason. I will follow my surgeon's or anesthesiologist's specific hold instructions, which may differ based on the type of procedure.
Fullscript Dispensary & Practitioner Disclosure
Transparency Disclosure · FTC & Texas Board Compliance
Important Financial Disclosure Regarding Fullscript
Navara Health, PLLC operates a Fullscript professional dispensary, which allows me to order practitioner-grade supplements through the practice. I understand and acknowledge the following:
- Navara Health receives a percentage of the purchase price for supplements I order through the Navara Fullscript dispensary. This is a standard practitioner dispensing arrangement and is disclosed to me as a matter of transparency.
- This financial arrangement is consistent with standard practice and is disclosed in compliance with FTC endorsement guidelines and Texas Board of Nursing / Texas Medical Board guidance on practitioner dispensing.
- Supplement recommendations are made based on my clinical needs, my labs, my goals, and the best available evidence — not on dispensary economics.
- I am under no obligation to purchase any recommended supplement, and I am under no obligation to purchase through Fullscript if I choose to take a recommended supplement.
- I may obtain supplements from any source I prefer — Amazon, retail stores, other practitioner dispensaries, or directly from the manufacturer.
- If I choose a non-Fullscript source, I am responsible for verifying the product I obtain matches the formulation, brand, and dose recommended.
- My choice of supplement source does not affect the care I receive from Navara Health.
- I may ask questions about Navara Health's relationship with Fullscript at any time.
Product Quality Considerations
When supplements are recommended, Navara Health selects products based on:
- Scientific evidence supporting the formulation and dosing
- Ingredient sourcing and purity (third-party testing, contaminant screening)
- Manufacturing quality (cGMP compliance, USP/NSF/ConsumerLab verification where applicable)
- Synergistic formulation and bioavailability (e.g., methylated B vitamins, liposomal delivery where appropriate)
- Standardization of botanical ingredients to active compounds
- Absence of unnecessary fillers, dyes, and allergens
I understand that:
- Professional-grade supplements (typically distributed through licensed practitioner channels) may cost more than retail consumer products
- Higher cost reflects quality control, ingredient testing, manufacturing standards, and formulation consistency
- Retail and online supplements vary widely in quality, ingredient identity, dosing accuracy, and contamination — and may not provide the same physiological effect or safety profile as professional-grade alternatives
- The supplement industry has documented quality issues, including label inaccuracy, undisclosed ingredients, and contamination in some products
No Guarantee of Results
I acknowledge that:
- Individual response to supplements varies based on genetics, gut health, current medications, lifestyle, and baseline status
- Results are not guaranteed
- Supplements may require time (often 6–12 weeks) to produce noticeable effects
- Dose adjustment, brand change, or discontinuation may be required based on response
- Lack of benefit does not imply improper care or negligence
- Some supplements work best when paired with specific lifestyle changes (nutrition, sleep, exercise, stress management)
Financial Disclosure
- Supplements are not covered by insurance
- I am financially responsible for any supplements I choose to purchase
- Navara Health does not bill or submit insurance claims for supplements
- Pricing is set by Fullscript or the third-party vendor; Navara Health does not control retail pricing
- Refunds and returns are subject to Fullscript or vendor policy, not Navara Health clinic policy
- Most supplement vendors do not accept returns of opened products
- Some Fullscript orders are eligible for HSA/FSA reimbursement; I am responsible for verifying eligibility with my plan administrator
Communication & HIPAA Authorization
I authorize Navara Health to communicate with me regarding supplement recommendations, refills, dosing changes, lab results, and follow-up through:
- The secure HIPAA-compliant patient portal
- Email to the address I have provided (including Fullscript invitation links and recommendation summaries)
- SMS / text message to the mobile number I have provided
- Telephone calls to the number I have provided
I understand that email and SMS are not fully secure channels. I may revoke authorization for any specific channel in writing to contact@navarahealthtx.com.
Limitation of Liability
I voluntarily assume all risks associated with the use of supplements, including those recommended by Navara Health, those purchased through Fullscript, and those obtained from other sources after recommendation. To the fullest extent permitted by law, I agree to release, indemnify, and hold harmless:
- Navara Health, PLLC
- Jessica Boggs, MSN, APRN, FNP-C, ENP-C
- The medical director and all affiliated providers, nurses, staff, contractors, and agents
from liability related to:
- Adverse reactions or side effects
- Interactions with medications, other supplements, or disease states
- Lack of expected results or treatment failure
- Product quality, contamination, or labeling issues attributable to the manufacturer or distributor (including Fullscript)
- Effects of supplements obtained from non-Navara-recommended sources
- Long-term or delayed effects not yet known
This release does not apply to cases of gross negligence or willful misconduct, and does not waive any right that cannot lawfully be waived under the laws of the State of Texas.
Per-Recommendation Acknowledgment
Documentation of Specific Recommendations (For Use At Each Visit)
Each time a specific supplement protocol is recommended for me, the following table will be completed by my provider and reviewed with me. My initials in the right-hand column confirm I understand the recommendation, the clinical reason, and that I have been given the opportunity to ask questions. This block may be left blank at initial signing of the master consent and completed at each visit thereafter.
| Supplement / Product |
Dose & Schedule |
Clinical Reason |
My Initials |
| | | | |
| | | | |
| | | | |
| | | | |
| | | | |
| | | | |
Visit Date: ____________________ Provider Initials: ____________________
Dispute Resolution & Governing Law
Any dispute, controversy, or claim arising out of or relating to this Consent or any supplement recommendation shall first be addressed by good-faith negotiation. If not resolved within thirty (30) days, the parties agree to submit the dispute to binding arbitration in Dallas County, Texas, under the rules of a recognized arbitration body. The parties waive the right to a jury trial.
This Consent shall be governed by the laws of the State of Texas. If any provision is found unenforceable, the remaining provisions shall remain in full force and effect.
Patient Initials — Required for Each Critical Clause
Each of the following requires my separate written initials.
I understand that supplements are not FDA-approved drugs and that statements about supplements have not been evaluated by the FDA (DSHEA disclosure).
I understand the specific interaction categories in Section 3, including risks with anticoagulants, antidepressants, thyroid medications, and GLP-1 therapy.
I understand the pre-procedure supplement hold guidance in Section 4 and agree to disclose all supplements to any surgeon, dentist, or anesthesiologist.
Fullscript dispensary disclosure: I understand that Navara Health receives a percentage of purchases through the Navara Fullscript dispensary, that I am under no obligation to purchase through Fullscript or to purchase recommended supplements at all, and that my choice of source does not affect my care.
I agree to disclose all medications, supplements, hormones, peptides, and therapies I am using at every visit, and to report adverse reactions promptly.
I agree to binding arbitration as described in Section 12 and understand that I am waiving the right to a jury trial.
Acknowledgment & Electronic Consent
By signing below (or by typing my full legal name as an electronic signature), I confirm and agree:
- I am at least 18 years of age.
- I have read and understand this Supplement Recommendation & Purchase Consent in its entirety.
- I understand that supplements are not FDA-approved drugs and are regulated under DSHEA.
- I understand the interaction risks described in Section 3 and the pre-procedure hold guidance in Section 4.
- I understand the Fullscript dispensary financial disclosure and that I am not required to purchase through Navara Health's dispensary.
- I have disclosed all current medications, supplements, hormones, peptides, and therapies to Navara Health, and I will continue to disclose any changes.
- I have had the opportunity to ask questions, and all questions have been answered to my satisfaction.
- I understand the Per-Recommendation Acknowledgment block (Section 11) will be completed at each visit when specific supplements are recommended.
- I voluntarily assume all risks and agree to the release of liability described in Section 10.
- I agree to binding arbitration as described in Section 12.
- I voluntarily consent to receive supplement recommendations and, if I choose, to purchase supplements through Fullscript or other sources.
- My typed name serves as my legal electronic signature, equivalent to a handwritten signature, and this consent becomes part of my permanent medical record.
Patient Signature (or Typed Electronic Signature)
Provider Signature — Jessica Boggs, APRN, FNP-C, ENP-C