Telehealth

Consent to Telehealth Services

All capitalized terms not defined in this Consent to Telehealth have the meanings set forth in the Terms of Use. For purposes of this consent, "OptivMD," "we," "us," or "our" refers to OptivMD LLC. "You" or "your" refers to the individual receiving or seeking Services.

Telehealth Services and Geographic Limitations

Telehealth (also referred to as telemedicine) involves the delivery of healthcare services using electronic communications, information technology, or other means between a licensed healthcare provider and a patient who are not in the same physical location.

You acknowledge and understand that:

• Telehealth services are provided only where permitted by applicable federal and state laws and regulations;
• Providers may only deliver care to patients located in states where the Provider is licensed, registered, or otherwise authorized to practice at the time of the consultation;
• Your physical location at the time of the telehealth encounter may affect the availability or scope of Services, including treatment options and prescriptions.

Telehealth services provided through the OptivMD platform may include, but are not limited to:

• Secure electronic transmission of medical records, images, personal health information, and related data;
• Real-time or asynchronous communications with Providers via audio, video, secure messaging, or data exchange;
• Review of information from connected devices, images, sound files, or video files, when clinically appropriate.

Privacy, Security, and Standard of Care

The electronic systems used in connection with OptivMD's Services incorporate administrative, technical, and physical safeguards designed to protect the privacy, confidentiality, and security of your health information, consistent with HIPAA and applicable state laws.

You understand that telehealth services are held to the same professional standards of care as in-person services, but that delivery via electronic means has inherent limitations and risks.

Prescription-Specific Disclosures

You acknowledge and understand that:

• Not all medical conditions are appropriate for diagnosis or treatment via telehealth;
• Providers may determine, in their sole clinical judgment, that a telehealth encounter is insufficient to safely prescribe medication;
• Certain medications, including controlled substances or other regulated drugs, may not be prescribed via telehealth due to federal or state law restrictions;
• Even when a prescription is issued, Providers are not required to prescribe any specific medication and may recommend in-person evaluation, diagnostic testing, or alternative treatment options;
• Regulatory requirements may limit available prescription options based on your location at the time of care.

Potential Benefits of Telehealth

Potential benefits of telehealth services include:

• Increased access to healthcare services;
• Greater convenience and flexibility in scheduling;
• Reduced need for in-person office visits.

Risks and Limitations of Telehealth

You understand and acknowledge the potential risks and limitations of telehealth, including:

• Incomplete or inaccurate information may affect clinical decision-making;
• Limitations in performing physical examinations or assessing vital signs;
• Possible delays in care due to technical issues or system failures;
• The potential, though unlikely, risk of unauthorized access to electronic information;
• The possibility that your condition cannot be appropriately evaluated or treated via telehealth.

Patient Rights, Consent, and Acknowledgments

By accepting this Consent to Telehealth, you confirm that:

• You have read and understand this Consent to Telehealth and have had the opportunity to ask questions;
• You voluntarily provide informed consent to receive healthcare services via telehealth from Providers affiliated with OptivMD;
• You understand that telehealth technologies and practices continue to evolve and may involve methods not specifically described here;
• No guarantees or assurances have been made regarding outcomes, and your condition may not improve and could worsen;
• Providers may determine that your condition is not appropriate for telehealth and may require referral for in-person or alternative care;
• The same confidentiality and privacy protections applicable to in-person healthcare services apply to telehealth services;
• You have the right to access your medical records in accordance with applicable law;
• You may withhold or withdraw consent to telehealth at any time by contacting OptivMD via email, subject to applicable legal or clinical limitations;
• If not withdrawn, this consent will be deemed renewed with each new telehealth encounter;
• You authorize Providers to use and disclose your health information for treatment, payment, and healthcare operations;
• You authorize Providers to disclose information related to your telehealth encounters to OptivMD and its affiliates as necessary to facilitate the Services.