Consultation Pathway

• Initial Consultation (In Person 20 minutes)

• Follow-Up Consultation (Telehealth, 20 minutes)

What to Expect from Your Male Hormone Optimisation Pathway

Treatment is only considered when both clinical features and biochemical evidence support a diagnosis of hypogonadism. There is no automatic prescribing.

Step 1: Book Online

Schedule your secure appointment via our portal.

Step 2: Initial Consultation (20 minutes)

Your doctor will:

• Take a full symptom history.

• Screen for red flags and reversible causes (e.g., sleep apnoea, obesity, medications, alcohol, opioids/anabolics, pituitary disease).

• Arrange diagnostic testing (pathology ± imaging) before confirming eligibility for TRT.

Step 3: Diagnostic Work-Up

Typically includes (where clinically appropriate):

• Two early-morning (before 9 am), fasting total testosterone levels on separate days (2–4 weeks apart).

• SHBG (to calculate free T if total T borderline/discordant).

• LH, FSH, prolactin, ± TSH.

• FBC/haematocrit, LFTs, lipids, HbA1c/fasting glucose.

• PSA (and prostate assessment depending on age/risk).

• Ferritin/iron studies, vitamin D, and others as indicated.

• Pituitary imaging if clinically warranted (e.g., very low T with low/normal LH/FSH, hyperprolactinaemia, visual symptoms).

Step 4: Follow-Up Consultation (Video, 20 minutes)

If results support a diagnosis of hypogonadism:

• Review and interpretation of results.

• Confirmation (or exclusion) of biochemical hypogonadism.

• Discussion of benefits, risks, alternatives, fertility implications, and formulation options.

• Shared decision-making on treatment planning.

Step 5: Treatment Planning (if appropriate)

• Formulation and dosing strategy tailored to patient goals, comorbidities, and logistics.

• Address contraindications/precautions (e.g., uncontrolled polycythaemia, high-risk prostate disease, severe untreated OSA, unstable cardiovascular disease, near-term fertility plans).

• Provide informed consent documentation and arrange monitoring schedule.

Step 6: Ongoing Monitoring & Safety

• 6–8 weeks after initiation/dose change: symptoms, adverse effects, testosterone (at trough/steady state), FBC/haematocrit, BP, ± PSA.

• 12 weekly Repeat Prescription Check-ins: reassess clinical response; adjust dose as required.

• 6 monthly Standard Reviews: symptoms, testosterone levels, FBC/haematocrit, LFTs, lipids, BP, PSA, and screening for OSA where indicated.

• Additional monitoring for high-risk or symptomatic patients.

Compliance & Clinical Standards

• No automatic prescribing; decisions are based on clinical assessment and documented justification.

• Two morning testosterone levels are mandatory for diagnosis.

• All treatment follows AHPRA and TGA requirements.

• Written informed consent is required for any off-label or compounded therapies.

Sexual Health Concerns We Assess and Manage

• Erectile dysfunction (difficulty achieving or maintaining erections)

• Premature ejaculation (shortened ejaculatory latency causing distress)

What to Expect from Your Appointment

Step 1: Book Online - Schedule your confidential consultation through our secure booking portal.

Step 2: Assessment (20 minutes via video call)

During your consultation, your doctor will:

• Take a detailed history of your symptoms, onset, and contributing factors (medical, psychological, lifestyle)

• Review your current health, medications, and risk factors (e.g. cardiovascular disease, diabetes, hormones)

• Arrange relevant investigations if clinically indicated (e.g. fasting glucose, lipids, testosterone, thyroid function)

• Develop an individualised treatment plan, with discussion of options, potential benefits and risks, and consent before prescribing or referral

Follow-up schedule:

• Online prescription reviews every 12 weeks

• Annual review required for continuation of therapy

• Male pattern hair loss (androgenic alopecia)

• Female pattern hair loss (androgenic alopecia)

• Alopecia areata (patchy autoimmune hair loss)

• Telogen effluvium (diffuse shedding often triggered by stress, illness, or hormones)

What to Expect from Your Hair Loss Telehealth Appointment

Step 1: Book Online - Use our secure booking system to schedule your consultation at a time that suits you.

Step 2: Hair Loss Assessment (20 minutes in-person)

During your consultation, your doctor will:

• Take a detailed history of your hair loss (onset, pattern, family history, lifestyle factors)

• Review your general health and medications

• Perform a trichoscopic examination of your scalp

• Arrange blood tests if clinically indicated (iron, thyroid, hormones, vitamin D)

• Provide an evidence-based treatment plan tailored to your type of hair loss, including discussion of medication options, potential benefits and risks, and consent before prescribing

Step 3: Ongoing Care and Monitoring- Hair loss treatment is long-term and requires regular review. Our follow-up process ensures:

• Monitoring for safety and effectiveness of prescribed medications

• Adjustments to treatment if your response changes over time

• Continued support with lifestyle and adjunctive strategies

Follow-up schedule:

• Online prescription check-ins every 12 weeks

• Annual review required for continuation of treatment

Regenerative procedures if indicated can also be arranged and performed in the clinic.

Skin Conditions We Assess and Manage

• Acne vulgaris (comedonal, inflammatory, nodulocystic)

• Rosacea (erythematotelangiectatic, papulopustular, phymatous, ocular)

• Seborrhoeic dermatitis (scalp, face, ears, chest)

• Keratosis pilaris (arms, thighs, cheeks)

• Photo-ageing (texture change, dyspigmentation, fine lines)

What to Expect from Your Skin Appointment

Step 1: Book Online - Use our secure portal to choose a time that suits you.

Step 2: Skin Assessment (20 minutes in-person)

Your doctor will:

• Take a targeted dermatologic history (onset, triggers, distribution, severity, prior treatments)

• Review medical history and medications (incl. hormonal factors )

• Take baseline photos of your skin

• Develop an evidence-based treatment plan for your condition, discuss options, risks, and obtain consent before prescribing

Step 3: Ongoing Care & Monitoring- Skin conditions often need weeks to months of consistent therapy. We’ll:

• Monitor safety and response

• Adjust treatment based on progress and tolerance

• Support trigger management, skin-care routines, and adherence

Follow-up schedule (default):

• Online prescription check-ins every 12 weeks

• Annual review for ongoing treatment

What we treat: epidermal, dermal, and mixed-type melasma (face predominately; photo-/hormone-associated pigmentation).

Consultation Structure (included in one total fee)

Part 1: Inital Assessment + Treatment Plan (20 minutes)

• Focused history (onset, pregnancy/OCP/HRT exposure, sun/heat exposure, skin type, prior treatments, irritant triggers, photosensitive meds).

• Review current skincare and sunscreen use.

• Arrange baseline photos (patient-supplied)

• Set treatment goals and timelines (realistic: improvement, not “cure”; relapse is common).

• Build a stepwise plan: initiation → consolidation → maintenance.

• Consent, written instructions, and scripts where appropriate.

Part 2: Tolerability Review (10 minutes, telehealth)

• Review history/photos

• Review tolerability to current treatment regime

Core Management (customised per patient)

1) Non-negotiables (start Day 1)

• Photoprotection daily: Broad-spectrum SPF50+ tinted sunscreen (iron oxides for visible light), 2-finger rule, reapply 2–3×/day outdoors.

• Heat/visible light minimisation: hats, shade, avoid peak UV; consider mineral/tinted formulations.

• Gentle skincare: non-foaming cleanser; barrier-supporting moisturiser; stop harsh scrubs/peels at home.

2) Prescription Treatment - Compounded topical preparations based on skin type/sensitivity ± Oral medication

Pregnancy/breastfeeding: current melasma treatments are contraindicated in pregnancy and breast feeding

3) Systemic / Adjuncts (case-by-case)

• For refractory disease after risk assessment (thromboembolism risks, migraine with aura, oestrogen use, smoking, clotting history).

Monitoring & Follow-Up

• Week 4-6: response/tolerability check; adjust actives (step up/down).

• Every 12 weeks: online prescription/supply review and photo-comparison.

• 6–12 months: maintenance planning; taper potent agents; long-term sunscreen + gentle actives.

What You’ll Receive

• Written plan (what to use, when, how much), sunscreen guide.

• Clear escalation/de-escalation rules and maintenance schedule.

What to Expect

Your consultation includes:

1. Comprehensive Assessment — detailed history, medication and supplement review, dietary and sleep evaluation, and symptom analysis.

2. Targeted Investigations.

3. Individualised Management Plan

4. Adjunctive Therapies — where clinically appropriate, Dr Maxwell may discuss evidence-informed options to support cellular energy pathways, such as nutritional and antioxidant support.

5. Follow-Up Consultation — review of results, adjustment of interventions, and assessment of progress.

Regulatory Compliance

• All prescriptions and treatments are provided in accordance with AHPRA, TGA, and RACGP clinical governance requirements.

• Patients are provided with written informed consent detailing the investigational nature, risks, and potential side effects of therapy.

• No claims of guaranteed benefit or cure are made.

Consultation Format

• Initial Consultation: 20 minutes — full history, examination, and pathology plan

• Follow-Up Consultation: 20 minutes — review of results and management discussion

• Format: Initial visit in-person with follow-up as Telehealth.

What to Expect from Your Appointment

Step 1: Book Online - -Choose a time via our secure portal.

Step 2: PED Risk Assessment (20 minutes via video call or in-person)

Your doctor will:

• Take a detailed PED history (compounds/classes, timing, route, ancillaries, adverse effects)

• Review medical/psychiatric history, meds, sleep, alcohol/recreational drugs

• Check vitals where available (BP, HR, weight) and screen red flags

• Arrange baseline investigations where clinically indicated (see below)

• Discuss options for harm minimisation, guided taper/cessation, and management of complications

• Obtain informed consent before any prescriptions, referrals, or monitoring plan

Step 3: Ongoing Care & Monitoring

We’ll provide a structured follow-up plan to:

• Track safety markers and organ health

• Adjust the plan based on results and symptoms

• Support cessation or risk-reduction goals (including mental health and fertility objectives)

Default follow-up schedule:

• Generally recommend 12 weekly review depending on risk factors (some treatment protocols may require more frequent Review)

• Annual comprehensive review (earlier if abnormalities are detected)

Treatment / Support Options Considered

• Harm Minimisation (while working toward cessation)

  • Education on real-world risks

• Guided Cessation / Recovery

  • Planned taper or stop with symptom monitoring (mood, libido, energy)

  • HPT-axis recovery strategies where clinically appropriate

  • Fertility-directed care (semen analysis tracking, endocrinology/urology referral)

• Management of PED-Related Complications

  • Erythrocytosis

  • Dyslipidaemia/Hypertension

  • Hepatic issues

• Gynecomastia

• Acne/derm changes

• Sleep apnoea

Referrals (as needed) i.e.

• Cardiology (symptoms, ECG/echo abnormalities, high CV risk)

• Endocrinology/Urology (HPT axis, fertility, complex cases)

• Dermatology (severe acne/scarring, alopecia)

Compliance & Scope

• This service provides medical risk assessment, monitoring, and support for cessation/risk reduction in the context of PED exposure.

• We do not advertise efficacy claims for non-approved substances and do not facilitate procurement.

• Management aligns with Australian primary-care standards; prescriptions (if any) are for approved, clinically indicated treatments (e.g., managing complications, supporting recovery), with informed consent.

Frequency: As outlined in your individual treatment plan.

This consultation is for ongoing patients and is designed to comprehensively review your treatment plan, monitor progress, and make any necessary adjustments to ensure continued safety and effectiveness.

Note:

1. A Telehealth review appointment is a mandatory part of your care every 6-12 months (depending on condition being managed) to meet clinical and regulatory standards.

2. Please refer to your Treatment Plan to the frequency of these reviews.

To review and re-prescribe medications under established treating plan.

Heading on a cruise, flight, or long trip and worried about motion sickness? Our telehealth travel sickness consult helps you feel confident and prepared before you go.

What’s involved:

1. Complete a quick online form with your travel plans, symptoms, and medical history.

2. Telehealth doctor review: An Australian-registered doctor assesses your risk factors and suitability for treatment.

3. Personalised management plan: Includes advice on lifestyle strategies, over-the-counter options, and, where appropriate, a prescription for travel sickness medication.

4. eScript sent directly to your mobile if medication is recommended.

Important: All treatment is provided in line with Australian clinical guidelines. Some medications may not be suitable depending on your health history.

Planning an overseas trip? Protect your health while you travel. Our Travel Health Consult provides tailored medical advice for your destination

Travel Health Consultation (Standard):

What’s included in standard consultation:

1. Online pre-travel form – share your itinerary, medical history, and concerns.

2. Telehealth doctor consult – review of health risks, travel vaccinations, food and water safety, and managing travellers’ diarrhoea and general infections.

3. Medication support – advice and, where appropriate, prescriptions for nausea relief, antibiotics for travellers’ diarrhoea, and other essential items.

4. Personalised plan – practical tips for staying safe and healthy during your trip.

Travel Health Consultation (With Malaria Prophylaxis):

Travelling to a malaria-risk area? Our comprehensive Travel Health Consult ensures you’re protected.

What’s included:

1. Online pre-travel form – provide details of your trip and medical background.

2. Telehealth doctor consult – review of malaria risk, travel vaccinations, and destination-specific health advice.

3. Malaria prophylaxis – selection of the most suitable medication (e.g. atovaquone/proguanil, doxycycline, mefloquine) based on your health, itinerary, and tolerability.

4. Additional support – prescriptions for common travel health needs such as nausea medication, antibiotics for travellers’ diarrhoea, and advice on insect bite prevention.

5. Personalised safety plan – covering malaria prevention strategies, food and water safety, and medical kit essentials.

Need time off work, school, or university for health reasons? Our online medical certificate request service makes the process fast and straightforward.

How it works:

1. Complete a short online form outlining your symptoms and reason for absence.

2. Doctor review: Your request is assessed by an Australian-registered doctor.

3. Certificate issued (if appropriate): A valid medical certificate is sent to you securely for work, study, or university.

Important: Certificates can only be provided where clinically appropriate, and may cover a maximum of 3 days without further consultation.