1. Program Overview
 

Purpose: This outlines the care management guidelines and patient responsibilities related to joining the weight management program at our practice, Arawan MedSpa + Wellness. It is designed to ensure transparency and consistency in the delivery of care, while also setting expectations for both patients and providers regarding treatment plans, costs, and scheduling.

 

Provider Responsibilities: Our approach is built around care management to help you succeed. Our program fee is structured to manage your care while you're on weight loss medication. You’re not just paying for the medication itself; you’re investing in expert guidance, personalized support, and ongoing monitoring to ensure you achieve your health and weight loss goals.

 

Consultation: Dr. de la Cruz will begin the treatment process with a thorough primary consultation to assess the patient's weight management goals, medical history, and overall health. This comprehensive consultation allows Dr. de la Cruz to establish a personalized treatment plan that aligns with the patient’s unique needs and concerns. Throughout the treatment, Dr. de la Cruz will follow-up weekly to monitor progress, discuss any challenges or successes, and make adjustments to the treatment plan as necessary. Once the patient reaches their weight loss goals, Dr. de la Cruz will work with them to transition off the weight loss medication, either through gradual dose reduction or by shifting to micro-dosing for long-term maintenance.

 

Monitoring: Dr. de la Cruz will closely monitor the patient’s response throughout the treatment process. This includes ongoing assessments to track weight loss progress, identify any side effects, and evaluate the overall effectiveness of the medication. Adjustments to the dosage or treatment plan will be made based on these evaluations to ensure the best outcomes. The goal is to maintain the patient on the smallest effective dose, which facilitates an easier transition off the medication once the weight loss goals are met. It is more difficult to taper off medications at higher doses, so Dr. de la Cruz will prioritize starting with the lowest effective dose to set the patient up for long-term success.

 

Education: Education is a key part of Dr. de la Cruz's treatment approach. Patients will receive detailed instructions on how to administer their injections at home (if chosen) and will be educated on potential side effects, how to manage them, and the importance of adhering to the prescribed weekly doses. Dr. de la Cruz will guide patients on how to incorporate diet, nutrition, exercise, and sleep into their routine for optimal effectiveness. The goal is to help patients not only achieve their weight loss objectives but also develop the tools and mindset necessary for long-term sustainability. Patients will be informed that transitioning off is easier when they are on a smaller dose, and that some may require ongoing microdosing even after adopting healthy lifestyle changes.

 

Care Management Continuity During Tapering: When you begin tapering off the medication and skipping a dose is prescribed during this process, care management continues. You continue to pay for receiving care management services such as, but not limited to weekly check-in follow up services, support, guidance, and monitoring necessary for a successful transition.

 

Patient Responsibilities With Behavior Modification For Sustainability: While prescribed medications serve as an effective tool in achieving weight management goals, sustainable results are contingent upon active participation in lifestyle and behavior modification efforts. Dr. de la Cruz emphasizes that the long-term maintenance of a healthy weight is achieved through continued adherence to healthy eating habits, regular exercise, proper recovery, and commitment to overall wellness.

 

Patients are encouraged to understand that the outcomes of their weight management journey are directly influenced by their dedication and consistent effort.

 

These lifestyle changes are essential, particularly when transitioning off weight loss medications. As the patient works toward tapering off the medication, maintaining these changes will support continued progress and prevent weight regain. However, some patients may need to remain on microdosing even with significant lifestyle modifications to maintain their results. Dr. de la Cruz will provide ongoing guidance on how to integrate these healthy behaviors into the patient’s daily routine, ensuring they have the tools to maintain weight loss in the long term, even if a low-dose maintenance approach is necessary.

 

Consistency is essential for the success of lifestyle behavior modifications aimed at maintaining a healthy weight. A lack of adherence to these modifications may increase the risk of weight regain. In such cases, patients may require additional support, including a potential return to medication-based interventions, to achieve their weight management goals. Patients are encouraged to prioritize ongoing lifestyle adjustments to sustain long-term results and minimize the need for further medical treatment.

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Patients will receive one weekly prescribed dose of compounded weight loss medication (e.g., Semaglutide, Tirzepatide) based on the physician's instruction.​
 

Program Success and Commitment: The success of this program depends on the Patient’s consistency and active participation in following the prescribed treatment plan. Regular attendance on weekly check-in follow-ups, adherence to dietary and lifestyle recommendations, and honest communication with the medical team are essential for achieving the desired results. The Patient acknowledges that Arawan is committed to providing support throughout their treatment journey, but ultimate success depends on the Patient’s full commitment.

 

Accountability and Program Adjustments: The Patient agrees to attend all scheduled appointments and follow the medical advice provided. If any difficulties arise in adhering to the program, the Patient is encouraged to communicate openly with the medical team. Adjustments may be made to the treatment plan as needed to fit the Patient’s specific needs. However, consistency is key to achieving long-term results.

 

Consequences of Non-Compliance: If the Patient repeatedly misses appointments, fails to follow prescribed guidelines, or otherwise does not comply with the treatment plan, the patient will not have a successful outcome. Arawan reserves the right to review the patient compliance status. In some cases, the program may be suspended or terminated, and applicable fees or penalties may apply.

 

Financial Obligation: Arawan MedSpa + Wellness does not accept any form of health insurance. Arawan provides cash-based treatments. Financing is available from Care Credit or Cherry Pay. The Patient understands that this Agreement is a binding contract, meaning the Patient is legally obligated to fulfill all terms, including remaining financially responsible for the full program term, regardless of compliance with the treatment plan. Program payments are non-refundable, and the Patient is required to fulfill their financial obligation, even if services are suspended or terminated due to non-compliance.

 

Continued Payments: Continued payments are considered acceptance of any updated terms and conditions. Program payments will continue as scheduled, regardless of pauses, extensions, missed treatments, travel, illness, or any other reason, unless otherwise agreed upon in writing. The Patient agrees to maintain their financial commitment throughout the program term.

No Extension of Program Term: Patients are responsible for managing their treatment schedule. Missed follow-ups that include missed doses may impact the effectiveness of the treatment and hinder progress toward weight management goals. The treatment term of the program remains fixed and will not be extended under any circumstances, even if a patient provides prior notice of absence or misses a scheduled weekly follow-up. While care management will continue, patients are strongly encouraged to adhere to weekly follow-up check-ins to achieve optimal results.

 

​Payment Issues, Late Fees, No-Shows or Late Cancellations: This fee helps cover the administrative costs and ensures that appointment times are available for other patients. Late cancellations and missed appointments can disrupt the scheduling and treatment continuity for both the patient and the clinic. 

• Late Payment Fees: If the payment is missed or declined, a $50 late fee will apply each time a late payment occurs, medical services will be suspended until full payment is settled. 

• Late Cancellation Fee and No Show Fee: Applies for missed appointments, cancelling, or rescheduling visits within 24 hours will incur a $100 late cancellation or no show fee. 

• After 120 days of non-payment, our weight loss medical services will be terminated and  the account may be sent to collections. 

 

​Continued Payments: Program payments will continue as scheduled, regardless of missed doses, travel, illness, or any other reason, unless otherwise agreed upon in writing. The patient agrees to maintain financial commitment throughout the program term.
 

Eligibility Criteria: Weight loss drugs are medications intended for patients with specific health goals and needs, including weight management. To qualify for treatment, patients must meet the following criteria:

1. Age Requirement: Patients must be 18 years or older. No pediatric weight management patients are accepted.

2. Health Status: Weight loss medications are primarily prescribed for patients with:

   • Overweight or obesity, as determined by BMI.

   • Patients with a waist-to-hip ratio (WHR) of greater than 0.90 for males and greater than 0.85 for females indicate that there is more fat around the waist compared to their hips. This ratio is often used as a measure of fat distribution in the body and is associated with health risks.

   • Someone who is already on an exercise regimen, behavior modification therapy, or on a nutritional coaching plan who needs medical weight management support.

   • No contraindications for the medication, such as history of certain medical conditions (e.g., thyroid cancer, pancreatitis).

   • Conditions where patients may benefit from weight loss medications include: type 2 diabetes, hypertension, dyslipidemia, obstructive sleep apnea, polycystic ovarian syndrome, joint and muscular disorders, cardiovascular disease, gastroesophageal reflux disease, and some psychological or mental health issues that impact self-esteem, body image, depression and anxiety related to being overweight or obesity.

3. Assessment: Patients must undergo a thorough health assessment to confirm that they are suitable candidates for care management. This includes an evaluation of current health conditions, weight loss history, and lifestyle factors.

4. Medical History Review: Prior to prescribing weight loss medications, we will review the patient’s medical history to ensure they meet appropriate clinical guidelines for the medication.

 

Patients who do not meet eligibility criteria may not be prescribed weight loss medications. Alternative weight management strategies will be discussed.

This Weight Loss Program Agreement ("Agreement") is made between the patient ("member" or “patient”) and Arawan MedSpa + Wellness, hereinafter referred to as "Arawan," for participation in the Medical Weight Loss Management Program ("Program"). By joining this program and reviewing the Weight Loss Program terms and conditions, the Patient acknowledges and agrees to the terms, guidelines, and requirements set forth in this Program Agreement.
 

PROGRAM TYPES

• Basic Care Plan: 24-week commitment with in-clinic visits.

• Enhanced Care Plan: Short Term In-Clinic Management.

• Convenience Care Plan: At-home care with weekly telehealth support.

  • Convenience Care Plan: For at-home telehealth care management, members pay a one-time fee for the duration of a medication volume amount or by medication expiration date.

2. Care Plan Structure and Terms:

• Basic Care Plan: 24-week commitment with in-clinic visits.

  • Basic Care Plan requires a 24-week commitment of in-clinic visits with ongoing care management provided for the full duration.

  • Payment Requirement: Payment is expected at the end of each 4th week cycle. This ensures continuity of treatment and access to services for the next upcoming 4-week cycle.

  • Payment Options:

    • Automatic Payments: Patients may set up automatic recurring payments, which will be debited from the credit card on file at the end of each 4th week cycle. Payment is expected every 4 weeks. 

    • Manual Payments: Patients may choose to make manual payments, but these must be completed by the end of each 4th week cycle to avoid late fees. The weekly cycle begins on Sunday and ends on Saturday. Payment is expected every 4 weeks. 

    • Late Payment Fee: Payments not received before the start of the next 4-week cycle will incur a $50 late fee for each late payment occurrence.

    • No Shows or Late Cancellations will be a $100 fee.

*By agreeing to these terms, the patient acknowledges their responsibility to make timely payments to avoid service interruptions and late fees.

• Enhanced Care Plan: Minimum four-week commitment with in-clinic management.

  • Minimum Commitment: Short-term in-clinic management is best managed with a minimum commitment of four weeks to ensure effective treatment and care. Optional plans are: week-to-week, 6-week, or 12-week plans. 

  • Complexity of Short-Term Management: Shortened commitments inherently involve greater complexity due to the unpredictability of treatment cycles. These factors are reflected in the structure of the care plan and associated fees.

  • Fee Structure: Fees for enhanced care management are calculated based on the complexity of treatment management. Shorter service durations may incur higher fees due to the increased complexity and intensity of care coordination required.

  • Payment Options:

    • Automatic Payments: Patients may set up automatic recurring payments, which will be debited from the credit card on file before each treatment cycle. Payment is expected every 4 weeks. 

    • Manual Payments: Patients may choose to make manual payments, but these must be completed at the beginning of each treatment cycle to avoid late fees.The weekly cycle begins on Sunday and ends on Saturday. Payment is expected every 4 weeks. 

    • Late Payment Fee: Payments not received at the beginning of the week of the next treatment cycle will incur a $50 late fee for each late payment occurrence.

    • No Shows or Late Cancellations will be a $100 fee. 

*By agreeing to these terms, patients acknowledge that service fees are determined by the level of care provided and the duration of the chosen plan.

• Convenience Care Plan: At-home care with weekly telehealth support.

  • Convenience Care Plan: For at-home care management, members pay a one-time fee for the duration of a medication volume amount or by the medication expiration date.

    • Weekly follow up check-ins will be done as a recurring visit.

    • Weekly check-in forms must be completed on Wednesdays between 7am CST and before 5pm CST to be considered on time.

    • To ensure timely processing, check-in forms must be completed on Wednesdays between 7:00 AM CST and 5:00 PM CST. Any forms submitted after 5:00 PM CST will be considered late and will incur a $100 administrative fee.

  • Medication Storage Responsibility: Patients are responsible for properly storing their medications both at home and during travel to ensure they remain effective. Improper storage may lead to the medication being denatured, and it is the patient’s responsibility to prevent this.

  • No Medication Replacements: Arawan and the care team, including Dr. de la Cruz, are not responsible for replacing any medications that are lost, damaged, or compromised due to improper storage or handling by the patient.

  • Non-Refundable Program Fees: Payment made covers the cost of the medication while supplies last, as well as expert care management provided by Dr. de la Cruz and his care team. Fees are non-refundable, regardless of the remaining supply of medication.

    • The fees are non-refundable because they cover both the medication (while supplies last) and the expert care provided by Dr. de la Cruz and the care team. The fee reflects the comprehensive management of your treatment, including time, resources, and administrative costs, which are not refundable regardless of the remaining medication.​​

  • Why Can’t We Send Syringes To Patients for Injections at Home?: 

    • We are not a licensed pharmacy and, therefore, cannot dispense medications directly to patients for home use. All medications must be labeled, have instructions from the pharmacy, and delivered directly from the pharmacy to the patient. 

3. Termination and Cancellation
 

Patient Cancellation: The Patient may cancel their program by providing written notice before the next billing date. If canceled before the end of the program term, an early termination fee equal to the remaining balance of the program term will apply. All fees paid are non-refundable, including payments for the agreed services for the full term and unused medication administration.
 

Termination by Arawan: Arawan reserves the right to terminate the program for non-payment of managed care and services, or non-compliance with treatment protocols, including failure to follow medical advice or attend required weekly check-in follow-ups.

 

4. Program Conditions
 

Non-Transferability: The program is non-transferable to another person.

Travel Considerations: If a patient plans to travel and will miss a dose, they should inform the clinic in advance to discuss potential options, but the standard policy will apply. The program will continue without pause, and missed doses will not be rescheduled. 
 

Missed Doses in Clinic: If a patient misses a scheduled dose at our clinic, the dose will be considered "used," and the patient will be charged for that visit.
 

Missed Doses Due to Personal Events or Personal Reasons: It is the patient’s responsibility to plan their personal events around their dosing schedule. Missed doses will not be refunded or rescheduled, as it may affect the treatment plan.

Missed Telehealth Visit: At-home participants are required to complete their weekly check-in forms on Wednesdays between 7:00 AM CST and 5:00 PM CST. Forms submitted after 5:00 PM CST will be considered late and subject to a $100 administrative fee. If an at-home participant does not respond or submit their form by 5:00 PM CST, it will be considered a missed telehealth visit, a $100 administrative fee is expected.

Medical Reasons: Patients who need to hold medication for medical reasons will be considered on a case-by-case basis. 

Service management fees, cost, or price are subject to change without notice.

Treatment Options for Short-Term Patients:

• Basic Plan: The 24-week program will continue as scheduled, and it is the patient’s responsibility to adhere to the treatment plan. The program cannot be paused for any reason, including travel, illness, or personal circumstances.

• Enhanced Plan: Patients who do not wish to commit to the full 24-week program may opt for a short-term management plan. 

  • Short-term patients will incur higher charges due to the complex management of a shorter duration.

  • Management Continuity: The patient will be closely monitored, and if they wish to continue after 8 weeks, they must transition to the 24-week commitment plan.

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Continued Payments: Program payments will continue as scheduled, regardless of pauses, extensions, missed treatments, travel, illness, or any other reason, unless otherwise agreed upon in writing. The Patient agrees to maintain their financial commitment throughout the program term.
 

No Extension of Program Term: The program term will not be extended under any circumstances, even if a patient provides prior notice of absence or misses a scheduled treatment dose. While patients are responsible for managing their treatment schedule, missed doses will not result in an extension of the program.
 

If a dose is skipped due to travel, illness, or any other reason, the patient will not be able to make up for missed doses at a later time. The total number of treatment doses in the program remains fixed, and the patient will continue to receive their doses according to the original schedule, regardless of missed appointments.

5. Suspension of Medical Treatment Services

Medical services may be suspended if the Patient’s account has outstanding balances due to declined payments, non-compliance with the program, or other issues. Services will remain suspended until the balance and any associated penalties are paid in full. Please note that any suspension of services due to payment issues or non-compliance will not extend the treatment plan or the program's duration. After 120 days of non-payment, our weight loss medical services will be terminated and the patient account may be sent to collections.

Notification and Resolution

• Notification of Payment Issue: The Patient will be notified of any payment issues and the suspension of services as soon as the issue is identified. Notification may be made in writing (via text, email, or mail) or by phone call, as appropriate.

• Late Fee: A $50 late fee will be applied if a payment is not received by the due date. The balance will continue to be invoiced and reattempted for payment daily.

• Suspension of Services: If the payment issue is not resolved, medical treatment services will be suspended. Services will remain suspended until the balance is paid in full, and the late fee is processed. The Patient will be notified when the suspension is lifted, and services will resume, subject to availability and clinic policies.

Reinstatement: Once the payment issue is resolved, services will be reinstated based on availability and clinic policies. Any missed treatments due to suspension may not be backtracked for treatment, rescheduled, or refunded. If services remain suspended for more than 30 days, Arawan reserves the right to terminate the program entirely.

6. Pregnancy: If the Patient becomes pregnant, weight loss medications such as GLP-1 receptor agonists may not be recommended due to potential risks. 

7. Discontinuation of Compounded Medication 

In the event that the prescribed medication (Semaglutide, Tirzepatide, or any other prescribed treatment) is discontinued or becomes unavailable for any reason (e.g., supply issues, regulatory changes, or medical reasons), the Patient will be eligible for a prorated refund.

8. Weekly Check-Ins and No-Show Policy: As part of the Medical Weight Loss Management program, weekly check-ins are required to monitor progress, assess treatment effectiveness, and provide ongoing support. These check-ins are essential to the Patient’s success in the program and to ensure that the treatment plan remains aligned with their health goals.

• Forms and Scheduling: The Patient is required to complete a weekly check-in form, which is available on Arawan’s website. The link to the form can be found under the Weight Loss Management tab. These forms should be submitted prior to or at the time of the weekly check-in appointment.

• Scheduling Weekly Check-Ins: To schedule a check-in, the Patient must use the scheduling link available on the Weight Loss Management tab of our website. Appointments should be scheduled on a weekly basis to ensure the Patient receives continuous support and monitoring throughout the treatment.

Scheduling: Patients are encouraged to schedule treatments in advance to ensure availability.

No-Show and Late Policy: Failure to attend an appointment or arriving more than 15 minutes late will result in a $100 no-show fee. The scheduled dose will be considered used.

Rescheduling: Appointments may be rescheduled with at least 24 hours’ notice, subject to availability.
 

9. Credit Card on File Policy

A valid credit card must be kept on file for billing purposes. By providing credit card information, the Patient authorizes Arawan to charge for program dues, service fees, missed appointment fees, and any outstanding balances.

Patients who choose not to keep a credit card on file and prefer to make manual payments are welcome to do so. However, any payments not received by the due date will incur a $50 late fee, which will be applied to the overdue balance. Timely payment is required to ensure uninterrupted participation in the program.

Patients are also responsible for paying for any missed appointments ("no-shows") or late cancellations, regardless of the payment method chosen.

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10. Privacy and Security

Data Protection: All personal and payment information is securely stored and encrypted in compliance with industry standards. However, Arawan cannot guarantee against potential security breaches.

Data Retention: Arawan will retain personal data, including payment information, for the duration of the program and for a reasonable period thereafter, in compliance with applicable data protection laws.

 

11. Dispute Resolution

Mediation and Arbitration: Disputes arising under this Agreement will be resolved through mediation or arbitration. All disputes will be governed by the laws of the State of Illinois.

12. Policy Updates

Arawan reserves the right to modify these terms and policies at any time. Updated terms will be posted on Arawan’s website. It is the Patient’s responsibility to review these updates periodically. Patients will be notified of material changes.

13. Acknowledgment
 

By reviewing and acknowledging this Program Agreement, the Patient confirms that they have read, understood, and agreed to all terms and conditions, including the full privacy policy, which is available on Arawan’s website at www.arawan.co.