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providers for ICATHInformed Consent for Access to Trans Health Care
Dear PROVIDER NAME:
NAME has met with a therapist/advocate regarding hormone use.
PRONOUN has discussed the following in regards to beginning hormone use:
Potential social consequences
Potential occupational consequences
Potential effects on familial relationships
Potential financial costs
Potential impacts on mental and physical health
NAME is informed on the psychosocial impacts of hormone use and is able to make an informed decision.
I, NAME, have explored the potential psychosocial impacts of hormone use and am able to make an informed decision.