Telehealth Informed Consent

Effective July 16, 2026

Effective Date: July 16, 2026 — Last Updated: July 16, 2026

Please read this Telehealth Informed Consent (“Consent”) carefully before your visit. It explains what telehealth is, its benefits and risks, your rights, and what you are agreeing to when you receive care through our telehealth services (the “Services”). By checking the box, electronically signing, or proceeding with a telehealth visit, you acknowledge that you have read and understood this Consent and voluntarily agree to receive care by telehealth. If you do not understand any part of this Consent, contact us before proceeding.

1. What Is Telehealth?

Telehealth is the delivery of healthcare services using electronic communications — including secure, real-time video and asynchronous (“store-and-forward”) messaging — with a licensed provider who is not physically present with you. During a telehealth encounter, your provider may review information you submit, evaluate your condition, discuss your history and symptoms, make a diagnosis where appropriate, recommend a treatment plan, order tests, and, when medically appropriate, prescribe medication. Telehealth may also include the electronic transmission of your medical records, images, and other information between you, your provider, and other health professionals involved in your care.

2. Consent to Receive Care by Telehealth

You voluntarily consent to receive healthcare services through telehealth. You understand that:

The provider delivering your care is a licensed health professional practicing within the scope of their license.
Telehealth is a mode of delivering care; it is not itself a guarantee that any particular service, diagnosis, treatment, or prescription will be provided.
Your provider will use their professional judgment to decide whether your condition can be appropriately evaluated and treated by telehealth, and may determine that an in-person evaluation is necessary.
This Consent supplements, and does not replace, any consent you give to a specific treatment, procedure, or medication during your visit.

3. Benefits of Telehealth

Telehealth can offer meaningful benefits, including:

Improved access to care, including for patients in areas with few local providers or with limited mobility;
Less travel and wait time, and greater scheduling convenience;
More privacy and comfort, since you can receive care from a location of your choosing; and
Timely treatment for conditions that can be safely evaluated and managed remotely.

Where a state requires a separate signed telehealth consent, we will present it for your acknowledgment before your visit.

4. Risks and Limitations

As with any medical service, telehealth has risks and limitations. You understand and accept that:

Information transmitted electronically may not be sufficient (for example, without a hands-on physical examination or in-person testing) for your provider to make a complete assessment or the most appropriate clinical decision.
Technology failures — including poor connectivity, hardware or software problems, or power or internet outages — may delay, interrupt, or prevent your consultation.
Without access to your complete medical history, there is a risk of an inaccurate assessment, a missed condition, or an adverse event such as a drug interaction or allergic reaction. Providing accurate, complete information reduces this risk.
The electronic transmission or storage of your information carries a small risk that security protections could fail and your information could be accessed by unauthorized persons, despite reasonable safeguards.
Telehealth is not appropriate for all conditions or all patients. Your provider may determine that your condition requires in-person care, urgent care, or emergency services, and may decline to treat or prescribe through telehealth.
Delays in evaluation or treatment could occur due to unavailability of your provider or technical difficulties.

5. Alternatives to Telehealth

Telehealth is one way to receive care. Alternatives include scheduling an in-person visit with a local provider, visiting an urgent care center, or, in an emergency, going to the nearest emergency room. You may choose any of these alternatives at any time.

6. Prescriptions and Controlled Substances

If your provider determines that medication is appropriate, a prescription may be issued and sent to a pharmacy for fulfillment. You understand that:

A prescription is never guaranteed and is issued solely at your provider’s professional discretion.
Your provider will not prescribe any medication they determine is unsafe, medically unnecessary, or not appropriate for evaluation and management by telehealth.
Prescriptions for controlled substances are limited and are issued only where permitted by applicable federal and state law, including the Ryan Haight Act and applicable Drug Enforcement Administration telemedicine rules.
You are responsible for using any prescribed medication as directed and for reporting side effects or concerns to your provider or seeking appropriate care.

7. No Guarantee of Outcome

You understand that the practice of medicine is not an exact science and that no guarantee has been or can be made regarding the results of any evaluation, treatment, or prescription provided through telehealth.

8. Your Provider, Credentials, and Licensure

You will be notified of your treating provider’s name, credentials, and state of licensure when your consultation is assigned and reviewed. You can view this information at any time in your Appointment Details on the patient dashboard. Your provider is licensed in the state in which you are located at the time of your visit and provides care within the scope of that license.

9. Your Rights

In-person care. You have the right to request or seek in-person care at any time. Choosing not to use telehealth will not affect your ability to obtain care elsewhere or your entitlement to future care.
Withdraw consent. You have the right to withdraw this Consent at any time, without penalty, by notifying us or your provider. Withdrawal applies to future care and does not affect care already provided.
Confidentiality. The same confidentiality protections that apply to in-person care apply to your telehealth visit. Your information is handled in accordance with applicable law, including HIPAA where applicable, and our Privacy Policy and Notice of Privacy Practices.
Ask questions. You have the right to ask questions about your care and this Consent at any time, and to receive information about your condition and treatment options in terms you can understand.
Access your records. You have the right to access your medical records as provided by law.

10. Privacy, Security, and Recording

We use reasonable administrative, physical, and technical safeguards to protect information transmitted and stored in connection with your telehealth visit. Your information will not be disclosed except as permitted or required by law and as described in our Privacy Policy and Notice of Privacy Practices.

Your telehealth visit and related messages may be documented in your medical record. We may record video visits only where lawful and with any notice or consent required by applicable law; recordings, if made, are part of your protected health information. You agree not to record any portion of your visit without your provider’s knowledge and consent.

11. Your Responsibilities

To help ensure safe and effective care, you agree to:

Provide accurate, current, and complete information about your identity, health history, medications, allergies, and symptoms;
Be in an appropriate, private, and safe location for your visit;
Follow your provider’s instructions and treatment plan, and arrange any recommended in-person care, testing, or follow-up; and
Promptly seek in-person or emergency care if your condition worsens.

12. Consent to Electronic Communications

You consent to communicate with us and your provider electronically — including by secure messaging, email, and text/SMS — in connection with your care and account. Ordinary email and text are not fully secure; please use the secure patient portal for health information. Standard message and data rates may apply.

13. Technology Requirements and Failure

Telehealth requires a compatible device, a supported browser or application, and a stable internet connection. If your consultation is interrupted or cannot be completed for technical reasons, contact [email protected] to reschedule or continue your visit. In a medical emergency, call 911.

14. Emergencies — Telehealth Is Not for Emergencies

Telehealth is not designed for emergencies. If you are experiencing a medical emergency, or believe you may be, call 911 or go to the nearest emergency room immediately. If you are having thoughts of harming yourself or others, call or text 988 (the Suicide and Crisis Lifeline). Your telehealth provider cannot dispatch emergency responders and may not be immediately available.

15. Audio-Only Services

We currently offer video consultations only. If audio-only service is added in the future, it will require separate consent before it is used.

16. Your Location

Care may be provided only where your provider is licensed and where you are physically located at the time of the visit. By proceeding, you confirm that the state on your registration reflects your actual physical location when receiving care, and you agree to update it if it changes. Providing an inaccurate location may prevent us from lawfully delivering care.

17. Consent for Minors

If care is provided to a minor, the parent or legal guardian establishing and managing the account represents that they are authorized to consent to the minor’s care and agrees to this Consent on the minor’s behalf, as permitted by applicable state law.

18. Financial Responsibility

You are responsible for any fees for the Services as disclosed to you, including any amounts not covered by insurance. Consenting to telehealth does not waive your financial responsibility for care provided.

19. Acknowledgment and Consent

By checking the box, electronically signing below, or proceeding with your telehealth visit, you acknowledge that:

You have read and understand this Telehealth Informed Consent;
You have had the opportunity to ask questions and those questions have been answered to your satisfaction;
You understand the benefits, risks, and limitations of telehealth and the alternatives available to you; and
You voluntarily consent to receive care through telehealth.