Patient Handbook

Four steps. The first three unlock your medication. The fourth sets up your app.

1. 1

   Send us your driver's license. Text or email a photo of the front. It links you to your medical record and is legally required for controlled substance prescriptions.

2. 2

   Sign your consent forms. They arrive by email right after your consultation. Check spam, and tell us if they don't show up so we can text them instead.

3. 3

   Upload your credit card. You'll get a secure link. Please enable autopay. This card covers membership, labs, medications, and supplies, but not commercial pharmacy meds like the ones from CVS, which you pay for at the counter.

4. 4

   Set up the MyLevel app. Within a day or two you'll get a secure link to finish setup. See the MyLevel app section below.

We've created a special app that lets you manage your entire regimen from one tap on your home screen. Once you've activated your account, your app lives at a web address: recessrx.mylevel.app. There's nothing to download. Open it in your browser and save it to your home screen. Review the sections below to hit the ground running from day one.

MyLevel is our precision-dosing method. Most clinics put everyone on the same fixed escalation schedule. MyLevel instead models how your body processes your medication and tunes your dose to keep you in the range where it works best.

Go deeper:

• How MyLevel works, with the charts and the science behind it.
• The clinical whitepaper, the dosing method validated on 112 patients.
• Dr. Ellis on the On The Pen podcast, on GLP-1 precision dosing.

Your first month is $399. That covers the cost of your membership and pays for provider time spent during your initial 30 days of treatment. Medications, labs, and supplies are billed separately, at cost.

The goal for month one: get you dialed in, confident with your injections, making real progress, and comfortable with your plan.

After the first month, care settles into a sustainable rhythm: keeping you dialed in, with monitoring that catches drift early.

What ongoing care looks like:

• Your plan, your choice.After month one you pick Concierge or Access, depending on how much support you want. Both keep wholesale medications and labs at cost. See Plans and Membership, below.
• Coaching keeps going.Weekly on Concierge, monthly on Access. Your RN Health Coach stays your first point of contact and brings your provider in when something needs a medical decision.
• Provider access.Anytime by text on Concierge. On Access, provider time is available a la carte at $79 per 30 minutes, arranged through the office.
• Refills become routine.Reorder in the MyLevel app before you run low. See Medications and Refills.
• Labs on a schedule.Once you're stable, hormone therapy patients typically test every three to six months. Your provider sets yours. See Labs.
• Check-ins still matter.Keep filling them out before each coaching session. They're how we catch the small things before they become big ones.

You can switch plans or cancel anytime as your needs change. See Switching or canceling.

If you're not fully dialed in by the end of month one, that's fine. We'll keep supporting you at that level as long as you need.

After month one, you choose.

What your membership covers: provider access, RN health coaching, and your care. That's it.

Billed separately, at cost: medications, labs, supplies, and a la carte provider time on the Access plan.

When you're charged. Your first month and your initial medication orders are billed shortly after your consultation. After that, your membership is billed once a month, around the same date it first charged. Medications, labs, and a la carte appointments are charged at the time of service, when the order goes in or the work is done.

Please enable autopay. It makes billing smoother for everyone.

We don't make money on medication. You pay our cost, plus a small surcharge for credit card fees, and that's the entire markup. We make nothing on what we prescribe, on purpose.

How medication orders work

We'll always tell you a medication's cost before we send it in. But once you say yes, by voice or text, the order is processed, filled, and shipped, with no further authorization. The charge hits your card on file and shows on your invoice.

There's no second confirmation, and no way to cancel after the fact.

Requesting a refill

Request refills in the MyLevel app. Don't wait until your last dose. Give yourself a week of buffer, since processing plus shipping can take a week and a half.

Timing

• New prescriptions.Once your consents and card are in, we send them the same day. Exception: a Friday consultation may go in Monday, since pharmacies rarely take new orders on Fridays.
• Refills.We aim for same day. Allow up to three days.
• Shipping.Typically 3 to 5 business days once the pharmacy ships. See Shipping, below.

We manage too many medications and peptides to list every side effect here. What matters is how we handle them. You're not alone, especially during the early months while we titrate your doses.

So we adjust. We personalize every medication to you and keep tuning it as your body tells us more. That's the point of MyLevel, and what your provider and coach are here for. Reach them through the contact directory.

You'll receive tracking information once your medication ships.

Retrieve your package the day it arrives. Anything refrigerated goes straight into the fridge. Never the freezer.

A package left on a porch for two July days may be ruined. Turn on carrier delivery notifications, and if you'll be away, have someone grab it.

If it hasn't arrived within a week of your order, tell us so we can start troubleshooting.

Some of what we prescribe, including testosterone, is Schedule III. That comes with extra rules. They aren't ours: they're state and federal law, and we follow all of them.

What this means for you:

• Photo ID required.You'll give it before we can prescribe, which is why we ask for your driver's license on day one.
• Refill timing.Set by the law in your state. We can't refill early, even by a few days, even with a good reason.
• Lost or stolen doses.Replacement is governed by state law and often isn't permitted.
• Prescription monitoring.Your state may check your prescribing history. It's routine and applies to every patient.

If a rule blocks something you need, tell us. We'll find what is available to you.

Required for hormone therapy patients. Optional for everyone else, though often worth doing.

Labs are provided at our cost, with no markup. They're typically drawn at Quest Patient Service Centers, and you can order them at any time.

Typical hormone therapy schedule. Your provider sets yours, and it may differ.

• Before starting therapy, to establish your baseline.
• One month in, to see how you're responding.
• One month after any major dose change.
• Every three to six months once you're stable.

Watch the instructional video below before your first injection. A subcutaneous injection goes into the fat just under the skin. An intramuscular one goes into the muscle. Your provider tells you which for each medication. Most of ours are subcutaneous.

Some reaction at the injection site is normal, especially with peptides. Here's what to expect, how to minimize it, and when to get help.

Storage. Follow each medication's instructions; your provider and coach will go over what needs refrigeration. Refrigerated meds go in the fridge, never the freezer, which damages most of what we prescribe.

Two good options:

• A sharps container.Available on Amazon or at any pharmacy for a few dollars. A one quart container lasts most patients months.
• A needle clipper.Easier for most people. It snips the needle off and stores it inside the clipper, so the syringe body can go in your regular trash. One clipper holds thousands of needles. This is the one we recommend.

When your container is full, seal it and follow your state's disposal rules. Many pharmacies, hospitals, and county household waste sites accept them at no charge.

Our custom loaded-syringe and supply cases keep your whole regimen organized, so you only get your vials and supplies out twice a month. Great for travel, too.

Take a look at the store.

We run on text and email. It's fast, and it's why you can reach your provider directly instead of leaving a voicemail.

So use a phone you control, and think about shared devices and family phone plans before you text us something you'd rather keep private.

For urgent but non-emergency situations during business hours, text your provider. If you can't reach them, text any other provider in the contact directory below.

Evenings, weekends, and holidays: we're happy to help when we can, but we can't guarantee a response until the next business day.

• Your provider.During your first month or any Concierge month. Medical questions, dosing, side effects, plan changes."Is this rash from the testosterone?" "I want to change my dose." "I've been nauseated for three days."
• Your RN Health Coach.Diet, training, injection technique, app trouble. Also medical questions once you're on the Access plan, where your coach is your front door and will bring your provider in when needed."My pen won't prime." "How much protein should I be getting?" "I can't get the app onto my home screen."
• The office.Billing, membership, and scheduling provider time on Access."I was charged twice." "I want to switch to Access." "I need to book a 30-minute appointment."

If you can't reach someone you need, text someone else. We'll make sure you get the attention you need.

Save these numbers in your phone so you recognize us when we reach out.