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ICATH stickers Here Now

We’ve got stickers for you!

To receive a sticker (or a few) please send a self-addressed/stamped envelope to:

ICATH
901 Boren Avenue STE 1300
Seattle WA 98104

Not required, though much appreciated: if you are able to include a couple cash dollars it will help offset the cost (everything we do is volunteer and out-of-pocket.) Thanks!

icath

Writing a letter with a Mental Health Counselor

***Replace all Green Font with your details***

providers for ICATHInformed Consent for Access to Trans Health Care

DATE

PROVIDER NAME
ADDRESS
ADDRESS
PHONE/FAX

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.

Sincerely,

NAME, CREDENTIAL
Therapist/Advocate

I, NAME, have explored the potential psychosocial impacts of hormone use and am able to make an informed decision.

Sincerely,

NAME                                               NAME
Patient                                             Parent/Guardian

Introduce Informed Consent to Your Medical Provider Using This Letter

 


providers for ICATHInformed Consent for Access to Trans Health Care


Dear Provider:

Thank you for working with me. As my provider you are in the position to offer me medical care that can support me to express my gender physically. I am writing this letter to request that you follow the standards of care outlined for this medication or procedure and allow us to use informed consent. I am aware of the following in regards to this gender affirming care and expect to discuss this with you in our appointment:

  • Potential social consequences
  • Potential occupational consequences
  • Potential effects on familial relationships
  • Potential financial costs
  • Potential impacts on mental and physical health

I am informed on the psychosocial impacts of this medical procedure and/or medication and am able to make an informed decision.

Sincerely,