Telehealth Informed Consent
Please read this before starting a visit.
DRAFT for legal review. Version 2026-07-01. Not final legal language.
Nature of telehealth
Telehealth involves the use of secure electronic communications to enable a licensed provider to evaluate and, where appropriate, prescribe for you without an in-person visit. You consent to receive care via telehealth, including asynchronous (messaging/questionnaire) review and, where required, live video visits.
Benefits and risks
Benefits include convenient access to care. Risks include, in rare cases, that information transmitted may be insufficient for the provider to make a clinical decision, that technical problems may occur, or that a condition may require in-person evaluation. Your provider will advise if telehealth is not appropriate for you.
No guarantee of treatment
Completing an intake does not guarantee a prescription. The provider prescribes only if they determine treatment is appropriate. You are charged only if you are prescribed.
Compounded medications
If prescribed, your medication may be compounded by a licensed pharmacy. Compounded medications are not FDA-approved and are not reviewed by the FDA for safety or efficacy.
Your rights
You may withdraw consent to telehealth at any time. You have the right to information about your provider and the dispensing pharmacy. Your health information is handled per our Privacy Policy. In an emergency, call 911.