Informed consent isn't really a thing once you get to surgeries. I know some surgeons are willing to take a letter from an HRT provider, but I can't recall which those are. Mine probably would, but she's on the east coast.
I will third the $320 recommendation for Dr. Graham. He is a good dude and will get you what you need as fast and painlessly as possible. I had 3 sessions total, all online text based chat, and had my letter about 3 weeks later in the mail from the UK.
Also Crane doesn't work in SF anymore. He is exclusively at the Austin location. Satterwhite does the top surgeries for Brownstein Crane in SF.