Dallas Patients:
You must have a BMI of 23 to qualify for our program. More than one yearly office visit may be required if your BMI drops below 23 while on the program or you have a condition that requires more frequent monitoring, such as borderline high blood pressure. We do not accept patients who are currently taking ADD or ADHD medication.
In compliance with federal and state regulations and laws that affect our medical treatment of our patients, in order for any of our Network Providers to treat any of our patients, must sign the following Network Treatment Agreement:
Registration / Initial Consult Fee is $100 and I will not be charged additionally by my physician at my appointment. This fee is non refundable after 30 days.
After my office visit, as long as my treatment is progressing well to my satisfaction (and my AT Provider), I will be able to log in to my online medical treatment account on the www.AbsolutelyThin.com website and complete a required monthly online progress note and submit payment of $80.00 for my physician to make a medical determination that a refill of my medication is indicated and submitted to the pharmacy of my choice to continue my treatment as I and my provider feel is medically necessary.
Office visits are required annually & are $100.
Absolutely Thin Treatment Agreement:
1. I agree that Dr. Branch and his associate physicians are treating me for my weight problem alone
and that he and his associated physicians are not treating me for any other medical condition.
2: I agree that I will follow my physician’s directions for care including my instructions for
taking my prescriptive medications EXACTLY.
3: I agree to keep my physician informed about my medical condition(s)
4: I will not get prescriptions from other doctors (or “Multisource” medications) for my weight loss needs while I am under Absolutely Thin medical care.
5: I have a primary care physician or a specialty care physician for whom I will seek medical care for any other medical problems I may have and that my Network Provider has no responsibility for treating me for these other medical conditions.
6: I have disclosed all pertinent health information, including any medications I am currently taking.
7: I understand that Absolutely Thin may contact me using forms of communication that include telephone, text message and/or email and I give them permission to do so.
8: I understand that the success of my weight management treatment depends on consistency & active participation in the program. Absolutely Thin cannot guarantee success or any definite outcome.
-I give you my permission to contact my PCP and get a copy of my medical records & discuss my care with them if needed.
-I understand and I agree that my ATIMAP doctor is treating me for weight problems alone & that I will have to go to my PCP or specialty physician for treatment of any other medical problems I have or may develop.
-I will follow his/her instructions for taking any medical prescriptions my ATIMAP doctor may give me exactly.
-I will not “multisource” or get similar prescriptions from other doctors while I am under treatment in the ATIMAP network system.
-I will keep my ATIMAP provider informed of my progress by completing required monthly progress reports on the www.AbsolutelyThin.com website.
-I will promptly let my treating doctor know of any new medications I am taking.
-Absolutely Thin & its affiliates may communicate with me via email, telephone, &/or text message.
-I have disclosed all pertinent health information.
Sincerely Yours,
R.E. Branch, M.D. and Staff