Welcome to Good Day Pharmacy!
Thank you for choosing Good Day Pharmacy and our partner, Amanda Spaak, NP, for your hormone health needs. We help high-performing women take control of their health through personalized, functional hormone care. This isn't cookie-cutter care—it's customized hormone optimization that addresses the root causes of your symptoms.

About Amanda Spaak, NP

Amanda is a Colorado native with 19 years of experience in medicine. She holds a Bachelor of Nursing from the University of Wyoming and a Master of Nursing from Colorado State University-Pueblo. As a Nurse Practitioner dually certified in Family Practice and Adult-Gerontological Acute Care, Amanda has witnessed firsthand how chronic illness impacts patients and families—and how traditional medicine often treats symptoms with medications rather than addressing root causes.

Driven by her passion for understanding the "why" behind health issues, Amanda turned to Functional Medicine. She believes in a preventive, holistic approach that empowers you to take charge of your health.

What is Functional Medicine?
Functional medicine is an approach to healthcare that focuses on identifying and addressing the root causes of disease. It views the body as an interconnected system and uses a combination of conventional medical practices and complementary therapies, including nutritional guidance, lifestyle changes, stress management, and supplements to improve health outcomes.

Unlike traditional medicine, which typically addresses symptoms, functional medicine looks for the underlying causes of health conditions, using a more holistic and patient-centered approach.

This is a Partnership
We provide the expertise—you commit to the process.

Through this partnership, Amanda will work with you to create a personalized treatment plan based on your unique symptoms, labs, and health goals. Whether you meet with Amanda in person in Fort Collins or virtually, this process is designed to help you feel your best through safe, effective, and fully customized care.

Your 6-Step Hormone Care Journey

Here's What You Get: A Step-by-Step Hormone Optimization Plan
We've built a 6-step process that removes the guesswork and delivers confidence, clarity, and lasting change.

1️⃣ STEP 1: Tell Us What You're Feeling

Complete your comprehensive health evaluation. Upon completion, you'll receive a link to complete a hormone symptom questionnaire and intake form. This becomes the foundation for your personalized hormone plan.

2️⃣ STEP 2: Lab Testing—Made Simple

Once Amanda reviews your intake forms, she'll send you personalized lab testing instructions based on your specific needs.

Lab work is ordered through Rupa Health ($325 for the Female Functional Wellness Panel)

Your lab panel includes two components:

Blood Work:

• Instructions will be emailed directly to you
• Schedule an appointment at any Quest Diagnostics lab center near you
• Find locations here: https://www.questdiagnostics.com/locations

Saliva Cortisol Test:

• A ZRT test kit will be mailed to your home
• Complete the test as soon as you receive it
• Return using the prepaid shipping label included in the kit

*Additional labs may be recommended based on Amanda's review of your evaluation

📩 Amanda will provide clear, step-by-step instructions for completing each test—without any confusion or unnecessary costs.

Important: To maintain consistency and ensure accurate results, we only accept lab work completed through our testing process.

3️⃣ STEP 3: Your Personalized Treatment Plan

Once labs are back (typically 7-14 days), Amanda will invite you to a 60-minute comprehensive consultation (virtual or in-person in Fort Collins). You'll receive:

• A customized hormone protocol
• Supplement recommendations
• Guidance on filling any prescriptions through our compounding pharmacy

💳 $350 consultation fee (your $50 deposit is applied, so the remaining balance is $300)

4️⃣ STEP 4: 4-6 Week Follow-Up Check

Complete a short follow-up form and meet with Amanda for a 30-minute check-in to make data-backed adjustments as needed.

💳 $150 for follow-up consultation

5️⃣ STEP 5: Ongoing Optimization

Amanda will continue to monitor your progress and make adjustments to ensure your plan remains optimized for your changing needs.

6️⃣ STEP 6: Additional Support (As Needed)

Once your plan is dialed in, you'll rarely need frequent follow-ups. However:

Annual Review (Required for BHRT patients):

• If you're on bioidentical hormone replacement therapy, an annual review is required to reassess your hormone levels, evaluate your progress, and ensure your treatment plan remains optimized for your needs

Additional Support (As Needed):

• 30-minute consultations available for adjustments or concerns
• Quick check-ins for questions between appointments

Scope of Services & Treatment Information

What Services May Be Provided

As part of your care at Good Day Pharmacy in partnership with Amanda Spaak, NP, we may provide the following services:

• Comprehensive health evaluations and medical assessments
• Diagnostic testing (blood tests, saliva tests, etc.)
• Personalized nutrition, supplement, and lifestyle recommendations
• Natural therapies (herbal medicine, nutritional support, etc.)
• Collaboration with other healthcare providers, if necessary
• Health coaching and educational resources

The Nature of Hormone Treatment

I hereby give my consent to evaluation and treatment by Good Day Pharmacy and Amanda Spaak, NP for the following condition(s):

Women: Menopause or menopausal symptoms (including potential repletion of estrogen/estradiol, progesterone, DHEA, testosterone)

Women: Other hormone imbalances - Thyroid abnormalities, Adrenal abnormalities

Important Treatment Information

I acknowledge that treatment with testosterone, bioidentical hormone replacement therapy, and thyroid optimization are considered off-label use of the associated medications and have not been FDA approved for the use of health optimization, wellness, or anti-aging purposes unless there is true medical necessity. I agree to the administration of hormone replacement therapy and medications designed to alter hormone levels, all as appropriate to my specific diagnosis, particular condition, and treatment objectives.

Alternative Treatments

I have been informed about alternative treatments and understand:

1. That we can leave the hormone levels alone
2. Treating age-related conditions as they appear
3. Using pharmaceutical agents that are not bioidentical in nature (synthetics)

I understand the alternative treatments and am choosing to consent to the treatment plan prepared for me by Good Day Pharmacy and Amanda Spaak, NP.

Benefits, Risks & Side Effects

Benefits of Functional Hormone Care

Functional medicine aims to address the root causes of your health issues, promote optimal wellness, prevent future illnesses, and improve quality of life. Many patients report positive outcomes, including improved energy, reduced symptoms, and enhanced well-being.

We will never guarantee specific results. Like all medical interventions, hormone therapy carries risks, and outcomes vary by individual. Our goal is to educate you thoroughly so you can move forward with confidence and clarity.

Potential Risks of Functional Medicine

As with any form of healthcare, there are risks, which may include but are not limited to:

• Adverse reactions to supplements, herbs, or other treatments
• Delay in diagnosis or treatment if conventional care is not integrated appropriately
• Emotional or psychological stress due to changes in diet, lifestyle, or treatment plans
• Unintended interactions between prescribed functional medicine protocols and medications you may be taking

Possible Side Effects for Women

Common side effects for women on estrogen, progesterone and/or testosterone may include:

• Breast swelling and/or discomfort
• Fluid retention
• Dizziness
• Thickening of the lining of the uterus (break-through bleeding)
• Acne
• Unwanted hair growth
• Headaches
• Slight deepening of the voice
• Slight enlargement of the clitoris
• Worsening of: (1) ovarian cysts, (2) uterine fibroids, (3) endometriosis, and (4) fibrocystic disease

Most common side effects resolve with time and can be treated by adjusting your hormone dose and adding other medications.

Serious side effects for women on hormone replacement therapy may include:

• Acceleration in the growth of gynecological cancers
• Elevations in hematocrit which could potentially predispose one to a blood clot
• Cardiovascular disease including heart attacks, strokes, and blood clots
• Potential increased risk of blood clots

Safety of Hormone Replacement Therapy

Although the majority of data points toward safety, there remains controversy regarding the correlation between the use of bioidentical hormone therapy and cancer. Recent data demonstrates that natural progesterone and estriol/estradiol may be protective against breast cancer.

Available data supports the safety of hormone replacement therapy in women. However, there still remains controversy regarding the correlation between bioidentical hormone replacement and cardiovascular events such as strokes, heart attacks, and blood clots. Some studies have shown correlations between hormone replacement therapy and cardiovascular disease while others show no correlation or even a benefit in preventing cardiovascular disease.

I understand that careful surveillance and close monitoring are requirements of all patients to minimize any possible risk.

Topical Hormone Precautions

I acknowledge that I should take extreme precaution if I am to use topical testosterone or hormone products. If a child or woman accidentally is exposed to the testosterone cream/lotion on my body, it could cause a significant increase in their hormone levels which could result in possible side effects.

What You Can Expect From Us

💡 Our Commitment to You
Honest, science-based communication with no hype or unrealistic promises

• A comprehensive evaluation to understand your health history, symptoms, and goals
• Lab work through Rupa Health/Quest Diagnostics ($325) to establish baseline hormone levels—additional labs may be recommended based on your evaluation
• A personalized treatment plan tailored to your results
• Ongoing support from Amanda and the Good Day Pharmacy team for guidance, adjustments, and follow-up
• Proven science and best practices—no guarantees, just expert care

Who's Supporting You?
Amanda Spaak, NP – Your Functional Medicine Provider

What Happens Next?

After submitting this form and making your $50 deposit, you'll receive:

✅ A secure link to complete your comprehensive health evaluation and symptom assessment

✅ An email from Amanda with lab testing instructions

✅ Full support from our team if you have questions along the way

⚠️ Don't Miss Important Emails!

Add info@gracefullivingfunctionalmedicine.com to your safe sender's list so you never miss a step in your hormone journey.

What We Expect From You

✅ Your Responsibilities

By moving forward with this partnership, you agree to:

Follow the plan: This includes recommended dosing, lab testing, follow-up appointments, and ongoing communication.

Continue routine medical care with your primary care provider or specialists for screenings (e.g., mammograms, colonoscopies, pap smears, pelvic exams, cardiac screenings, DEXA scans, etc.).

Report any adverse reactions or concerns promptly to Amanda or your medical provider.

Communicate via email when appropriate and consent to receive secure communications about your care, including Personal Health Information (PHI). You may revoke this consent at any time in writing.

Accept financial responsibility: Lab tests, consultations, and medications are typically not covered by insurance. You agree to pay out-of-pocket with no guarantee of reimbursement.

Provide accurate and complete medical information, including current medications and health history.

Understand that results may vary from person to person and that functional medicine is not a guaranteed cure for any specific condition.

Keep scheduled appointments and notify us if you need to reschedule.

Work collaboratively with your healthcare providers and seek emergency or urgent medical care when necessary.

Critical Health Screenings

I understand that Good Day Pharmacy and Amanda Spaak, NP will monitor my hormone levels and various laboratory values as they pertain to my treatment goals. However, I also understand that an integral part of health maintenance is obtaining and remaining up to date with age-appropriate screening tests aimed at early detection of life-threatening diseases.

I agree to obtain and remain up to date on all age-appropriate screenings, including, but not limited to, DEXA scans, mammograms, PAP smears, pelvic exams, colonoscopies, cardiac screenings, and any other type of recommended health screenings.

Mammogram Requirement: Amanda Spaak, NP, strongly recommends obtaining yearly mammograms. I understand that certain types of breast cancer, once present, can be stimulated to grow faster by estrogen that is prescribed or even the estrogen within your body. Therefore, it is imperative to obtain appropriate yearly screenings.

I agree to obtain these screenings through the direction of my primary care provider and/or OB/GYN and/or cardiologist and will not hold Good Day Pharmacy, Amanda Spaak, NP, or any additional staff responsible or liable for performing these health maintenance screenings or the treatment of any other conditions not relevant to my treatment goals.

Pregnancy Notification

I agree to notify Good Day Pharmacy and Amanda Spaak, NP, immediately if I am to become pregnant while on hormone replacement therapy and to stop it immediately. I understand that being on hormone therapy and becoming pregnant could present a risk to an unborn child.

Primary Care Relationship

I certify that I am under the regular care of a primary care provider or an OB/GYN or a Women's Health Specialist for any other conditions I might have or may be found to have. I will consult with my primary care provider or specialist regarding any other condition I might have. I understand that if I do not have a primary care provider, I will be encouraged to seek one out.

I acknowledge that I am seeking care at Good Day Pharmacy and with Amanda Spaak, NP for specialized hormone care services. I acknowledge I am not wanting to establish primary care and I am here for specialized hormone optimization and functional medicine care.

Who Should NOT Proceed

🚫 Hormone Care Not Currently Recommended If You:
Please review the following exclusion criteria carefully. If any of these apply to you, hormone replacement therapy may not be appropriate at this time:

❌ Are currently using hormonal birth control or a hormonal IUD

• (We can help you transition off, but hormone balancing isn't possible while using synthetic hormones)
• ✅ Exception: Copper IUD (ParaGard) is acceptable

❌ Have a history of breast cancer or a strong family history of breast cancer

❌ Have Polycystic Liver Disease

❌ Are under the age of 35 and experiencing perimenopausal symptoms (please consult your physician first)

❌ Are currently smoking or vaping

(We strongly advise quitting before starting hormone therapy. Smoking may prevent safe estrogen therapy.)

Starting Treatment Before Screening Results

I want to initiate treatment with Good Day Pharmacy and Amanda Spaak, NP and I give permission to begin treatment without knowing results of age-appropriate and health maintenance screenings.

In doing so, I release Good Day Pharmacy, Amanda Spaak, NP, and other healthcare practitioners of any claims of liability for cardiovascular events, ovarian cancer, breast cancer, uterine cancer, cervical cancer, and/or colon cancer.

Further, I agree to immediately notify Good Day Pharmacy and Amanda Spaak, NP of any abnormal findings on any health screenings done by my primary care provider.

Privacy & Confidentiality (HIPAA Notice)

HIPAA Notice of Privacy Practices

This notice describes how medical information about you may be used and disclosed by Good Day Pharmacy and Amanda Spaak, NP, and how you can get access to this information. Please review it carefully.

Your Rights

When it comes to your health information, you have certain rights:

Get an electronic or paper copy of your medical record

• You can ask to see or get a copy of your medical record and other health information we have about you
• We will provide a copy or summary, usually within 30 days of your request
• We may charge a reasonable, cost-based fee

Ask us to correct your medical record

• You can ask us to correct health information about you that you think is incorrect or incomplete
• We may say "no" to your request, but we'll tell you why in writing within 60 days

Request confidential communications

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address
• We will say "yes" to all reasonable requests

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment, payment, or our operations
• We are not required to agree to your request, and we may say "no" if it would affect your care
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information with your health insurer

Get a list of those with whom we've shared information

• You can ask for a list (accounting) of the times we've shared your health information for six years prior to the date you ask
• We'll provide one accounting a year for free but will charge a reasonable fee if you ask for another one within 12 months

Get a copy of this privacy notice

• You can ask for a paper copy of this notice at any time

Choose someone to act for you

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information

File a complaint if you feel your rights are violated

• You can complain if you feel we have violated your rights by contacting us at: or info@gracefullivingfunctionalmedicine.com
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights
• We will not retaliate against you for filing a complaint

Your Choices

For certain health information, you can tell us your choices about what we share:

You have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care
• Share information in a disaster relief situation
• Include your information in a directory

If you are not able to tell us your preference (for example, if you are unconscious), we may share your information if we believe it is in your best interest.

We never share your information unless you give us written permission for:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

How We Use Your Health Information

Treat you: We can use your health information and share it with other professionals who are treating you.

Run our organization: We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Bill for your services: We can use and share your health information to bill and get payment from health plans or other entities.

We never market or sell your personal information.

Other Uses of Your Information

We are allowed or required to share your information in ways that contribute to the public good, such as:

• Public health and safety (preventing disease, reporting adverse reactions)
• Health research
• Complying with the law
• Organ and tissue donation requests
• Working with medical examiners or funeral directors
• Workers' compensation, law enforcement, and government requests
• Responding to lawsuits and legal actions

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information
• We will let you know promptly if a breach occurs
• We must follow the duties and privacy practices described in this notice
• We will not use or share your information other than as described here unless you tell us we can in writing

Confidentiality

Your privacy is important to us. All personal health information you provide will be kept confidential and shared only with those involved in your care, as permitted by law or with your explicit consent.

Legal Disclaimer & Release of Liability

⚖️ Legal & Medical Disclaimer

By signing this form, you acknowledge and agree to the following:

You acknowledge that:

• All risks, potential side effects, and benefits have been explained to you
  Your questions have been answered and you are not proceeding under false assumptions
• Any questions you have regarding this treatment have been answered to your satisfaction
• You understand that you will be responsible for administering the hormones and/or medications prescribed to you if you do not have them administered in clinic
• You promise to comply with the dosages and frequency of medications prescribed to you

You understand that:

• This is an elective, patient-directed process supported by medical expertise—but not a substitute for ongoing care with your primary care physician
• Treatment modalities utilized might not be supported by scientific/medical literature and could be seen as experimental or based on anecdotal claims
• Many medical providers, including endocrinologists and OB/GYNs, might see these types of treatments as not medically necessary
• Functional medicine is not intended for emergency care. In case of an emergency, you will seek immediate medical attention from an appropriate emergency healthcare provider

You release and hold harmless:

• You have reviewed the mentioned risks and have determined the benefits outweigh the possible risks associated with hormone restoration and treatment
• You release Good Day Pharmacy, Amanda Spaak, NP, Graceful Living Functional Medicine & Nutrition, and their affiliates from liability related to treatment complications or outcomes
• You release any claim in court or any type of complaint that could result from treatment and will not hold liable any provider or staff

You have the right to:

• Seek alternative treatments and consultations from other healthcare providers
• Discuss any concerns or preferences regarding your treatment plan
• Withdraw your consent at any time

Final Consent & Payment
✍️ Informed Consent

You are making a decision to invest in your health with full understanding and transparency.

By signing, you confirm that you:

✅ Fully understand, accept, and agree to all terms outlined in this comprehensive informed consent

✅ Have read and understood the information about functional medicine and hormone replacement therapy

✅ Understand the potential risks and benefits

✅ Have had the opportunity to ask questions and receive satisfactory answers

✅ Voluntarily consent to evaluation, treatment, and care provided by Good Day Pharmacy and Amanda Spaak, NP

✅ Understand your participation in this process is voluntary and you can withdraw consent at any time

✅ Acknowledge receipt of and agree to the terms outlined in the HIPAA Notice of Privacy Practices

✅ Request to begin personalized hormone care under the partnership of Good Day Pharmacy and Amanda Spaak, NP

💳 Secure Your Spot: $50 Deposit
A one-time, $50 non-refundable deposit:

• Locks in your spot with Amanda
• Allows Amanda to review your comprehensive evaluation
• Is applied toward your $350 consultation (you'll only owe $300 at the time of your appointment)