Sample agreement — for information only — not for signing

Youth Revisited

Sample TRT Agreement

This is an example of the agreement your clients sign. All terms, inclusions, and pricing shown exactly as they appear in the real document.

About this document

What your clients sign

This sample shows you the full agreement your clients will receive following their consultation. Every clause, every inclusion, every term — exactly as written.

Your personalised agreement is sent to you directly after your initial consultation and clinical approval. It will be pre-configured with your chosen plan and medication.

Book a consultation

Your journey

Step 1

Initial consultation

Speak with the team about your health history, symptoms, and goals.

Step 2

Clinical review & approval

A prescriber reviews your case and confirms you are suitable to proceed.

3

Step 3

Sign your agreement

Your personalised agreement is sent to you. Review, sign, and you're in.

Monthly rolling — no minimum

Monitoring Only

£95/month

Quarterly blood panel, prescriber review, results dashboard, and clinical support. Self-source your medication.

Quarterly commitment once prescribed

Monitoring + Medication

£150–175/month

Monitoring included

Everything in monitoring, plus medication dispensed by a UK pharmacy and posted to your door.

Medication options — monitoring included in all prices shown:

Sustanon

£150/mo

Monitoring included

Intramuscular injection. UK pharmacy dispensed.

Testosterone Cypionate

£195/mo

Monitoring included

Intramuscular injection. Preferred for stable levels.

Testo Gel

£175/mo

Monitoring included

Topical gel. Applied daily. Needle-free.

Testosterone Enanthate

£325/mo

Monitoring included

Premium tier. Intramuscular injection. Prescribed on clinical assessment.

Optional: Biomarker Upgrade — +£100 per quarter (ad hoc). Upgrade any quarterly test to the extended Biomarker profile covering performance, recovery, and metabolic health. Chosen each quarter when your test is due — not a recurring commitment.

Example monthly total

Monitoring + Testosterone Cypionate

Your plan total£95–£325/month

Quarterly Blood Panel

Every 3 months — home visit phlebotomy included

Hormone Panel

Total TestosteroneSHBGLH & FSHProlactin

Safety Markers

Full Blood CountHaematocritPSA (Prostate)HbA1c

Organ Function

Liver Function (LFT)Lipid Profile

* Cortisol added for clients with previous steroid use. Additional markers may be requested by your prescriber if clinically indicated.

Included & not included

Monitoring + Medication tier shown

Included

Quarterly blood panel — all markers above
AI-assisted report reviewed & signed off by Nemia Pilobello (NMC IP) under oversight of Dr Ahmed
Optional quarterly call with prescriber or doctor
Personal results dashboard
Named personal contact Mon–Fri 9am–5pm
Quarterly prescription issuance
Medication posted by SignatureRx (GPhC reg.)
Needles, syringes & sharps bin — quarterly (injection clients)
1:1 Zoom injection tutorial before first administration

Not included

Medication (unless medication tier selected)
Needles/sharps for Testo Gel clients
HCG, aromatase inhibitors, unprescribed ancillaries
Medical letters, GP correspondence, referrals
Investigations unrelated to TRT/hormone health
Emergency or out-of-hours cover
Biomarker upgrade (optional, +£100/quarter)

Key terms

Applies to all plans

Billing

Monthly

Collected by Direct Debit via GoCardless.

Prescribing cycle

Quarterly

One prescription covering 3 months, issued at start of each quarter.

Cancellation

7-day window

Cancel within 7 days of signing before first DD. After that, 30 days notice (monitoring) or end of current quarter (medication).

Blood tests

Every 3 months

Prescribing paused if required tests are not completed.

TRT Monitoring Subscription Agreement

Youth Revisited Ltd — sample terms shown below. Your personalised agreement will be sent following consultation.

1. Purpose

What this agreement covers

This agreement sets out the terms under which Youth Revisited Ltd provides TRT monitoring, clinical oversight, quarterly blood testing, and — where selected — medication supply. This subscription does not include TRT medication unless the Monitoring + Medication tier has been selected. This subscription is not active until countersigned by the Provider following clinical eligibility review.

2. Subscription & term

Commencement & cancellation window

By signing this agreement the Client requests that the subscription commences immediately. A cancellation window of 7 days applies from the date of signing, provided no Direct Debit payment has been taken and no medication has been ordered. After this period, or once the first payment is collected, the subscription terms apply in full.

3. Blood testing

Quarterly panel — every 3 months

A full hormone and health blood panel is carried out every 3 months. The standard panel includes: Total Testosterone, SHBG, LH & FSH, Prolactin, Full Blood Count, Haematocrit, PSA, HbA1c, Liver Function (LFT), and Lipid Profile. Cortisol is added where there is a history of steroid use. Failure to complete required blood tests may pause clinical oversight and any prescribing.

4. Optional upgrades & specialist investigations

Additional services available on request

Biomarker Upgrade — £100 per quarter (ad hoc): Upgrade any quarterly test to the extended profile. Not locked in at signing.

Specialist investigations: Investigations related to TRT and hormone health are available where clinically appropriate. Cost varies. Contact the team for details.

Additional consultations: Available on request outside your quarterly review. Pricing varies — contact the team.

5. What you receive

Included in your subscription

Blood testing: Quarterly panel at home or clinic.

Results & clinical review: AI-assisted report reviewed and signed off by Nemia Pilobello (NMC Independent Prescriber), under medical oversight of Dr Salman Ahmed (GMC #7948448).

Quarterly consultation: Optional call with Nemia Pilobello or Dr Ahmed each quarter — included at no extra cost.

Support: Named personal contact Mon–Fri 9am–5pm.

Prescriptions: Issued quarterly by Nemia Pilobello when clinically appropriate.

Dashboard: Personal biomarker dashboard across all quarters.

Medication tier only: Medication via SignatureRx (GPhC reg. 9012267) • Needles, syringes & sharps bin quarterly (injection clients) • 1:1 Zoom injection tutorial before first administration.

6. What is not included

Excluded from this subscription

TRT medication (unless medication tier) • Needles/sharps for Testo Gel clients • HCG, aromatase inhibitors, unprescribed ancillaries • Medical letters, GP correspondence, referrals • Investigations unrelated to TRT/hormone health • Emergency or out-of-hours cover • Biomarker upgrade (optional, +£100/quarter).

7. Pricing

Monthly cost — monitoring included

Monitoring Only: £95/month. Monitoring + Sustanon: £150/month. Monitoring + Testosterone Cypionate: £195/month. Monitoring + Testo Gel: £175/month. Monitoring + Testosterone Enanthate: £325/month. All prices include monitoring. Medication costs are non-refundable once dispensed.

8. Payment

Direct Debit via GoCardless

Payment collected monthly by Direct Debit via GoCardless. First payment taken 7 days after signing. Subscription not activated until mandate is confirmed. Provider reserves right to suspend services if payment fails.

9. Prescribing cycle & cancellation

How cancellation works alongside quarterly prescribing

Monitoring Only: Cancel anytime with 30 days' written notice to info@youth-revisited.co.uk after the 7-day window.

Monitoring + Medication: Prescriptions issued quarterly. Once a prescription is issued and medication dispensed, all three monthly payments for that quarter are committed and due in full. Cancellation takes effect at end of current billing quarter. No further prescriptions issued after notice is given.

10–14. Medical suitability, responsibilities, risks, liability & GDPR

Full terms in your personalised agreement

Your countersigned agreement will contain the full terms covering clinical discretion, client responsibilities, informed consent to TRT risks, limitation of liability, and UK GDPR data processing. All are set out in plain language in your personal document.

Important notes

This is a sample document for information only. Your personalised agreement will be sent to you following your consultation and clinical approval.

Subscription active from signing. First Direct Debit taken 7 days after signing. Cancel within 7 days with no charge, provided no medication has been ordered.

For medication tier clients: once a quarterly prescription is issued, all 3 monthly payments for that quarter are committed. Cancellation takes effect at quarter end.

Results reports are AI-assisted and reviewed and signed off by Nemia Pilobello (NMC IP) under Dr Ahmed's oversight.

Youth Revisited Ltd is not a replacement for your NHS GP. This is specialist TRT monitoring — not general medical care.

Ready to start?

Book your consultation

Your personalised agreement is sent to you following your initial consultation and clinical approval. It will be pre-configured with your chosen plan, medication, and pricing.

Book a consultation
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