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A well-structured protocol for a 65-year-old with suboptimal IGF-1, sarcopenia, and visceral adiposity might look like this: Baseline labs IGF-1, GH stimulation assessment, HbA1c, fasting insulin, CMP, CBC, lipid panel, PSA (men), thyroid panel, DEXA scan for bone density Peptide selection typically sermorelin or low-dose CJC-1295/ipamorelin for GH axis support

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The progress note must name which criterion applied, describe how it affected the session, and state the specific clinical response

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