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Telehealth Medical Consent

I. Introduction


You are reviewing and acknowledging this Telehealth Informed Consent because you are seeking healthcare services utilizing telehealth technologies facilitated through the Healthie website, iOS mobile app, web mobile app, or other telehealth technologies, collectively the “Healthie platform.” This Telehealth Informed Consent supplements and does not modify or supersede any Terms of Use, Privacy Policy, or Notice of Privacy Practices of Healthie or your healthcare provider(s).


By creating an account, starting a consult, clicking “I consent to telehealth,” checking a related box to signify your acceptance, or using any other acceptance protocol presented through the Healthie platform, you indicate that you have reviewed the risks described herein of receiving services using telehealth technologies and consent to receiving these services. A record of this Telehealth Informed Consent is maintained in the files and records of the provider delivering your services, and your ongoing use of telehealth services serves as your continued acknowledgment of and agreement to this consent.


II. What is Telehealth?


Telehealth involves the delivery of health and wellness services using electronic communications, information technology, or other means between a licensed, certified, or registered healthcare professional at one location and a patient at another. Telehealth may be used for diagnosis, treatment, follow-up, and/or patient education. These services may involve asynchronous interactions, real-time (synchronous) video and audio sessions, and interactive audio using store-and-forward technologies. This consent outlines the treatment methods, risks, and limitations associated with using telehealth to support your healthcare needs.


III. What are the Possible Benefits of Telehealth?


Benefits of telehealth include easier and more efficient access to healthcare. You may obtain services at times that are convenient for you, without needing an in-person appointment. This may also include follow-up care. If you need follow-up services, you can contact your provider directly through the Healthie platform.


IV. What are the Possible Risks of Telehealth?


  • Information shared electronically may not always be sufficient to make appropriate clinical decisions.
  • Some health issues may not be suitable for telehealth and may require in-person evaluation.
  • Technology failures (e.g., internet or device issues) may disrupt or delay your care.
  • In rare instances, incomplete medical records or poor data quality may lead to misdiagnoses or ineffective treatment.
  • You may stop or decline ongoing telehealth services at any time; however, fees may still apply for services already rendered.


Diagnostic testing services offered via the Healthie platform may involve third-party labs. While these tests support clinical care, they may occasionally produce inaccurate or inconclusive results. Such limitations may impact the quality or accuracy of your care.

Third-Party Laboratory Products and Services:


Providers may recommend that you undergo diagnostic tests. These tests are conducted by third-party laboratories, and neither Healthie nor your provider can guarantee the reliability of these tests. Errors such as false positives or false negatives may impact your diagnosis or treatment.


V. Patient Acknowledgments


By accepting this Telehealth Informed Consent, you acknowledge and agree that:

  • You understand the risks, limitations, and benefits of telehealth services.
  • Electronic communication increases privacy risks compared to in-person care.
  • Your provider may be a nurse practitioner or physician assistant.
  • Other personnel may be present during your session for technical support or language assistance, and you will be informed of their presence and role.
  • All information you provide is accurate, complete, and truthful.
  • Your provider may determine that asynchronous communication (e.g., store-and-forward) is appropriate. You agree to receive care this way when advised.
  • There is no guarantee that you will receive a prescription; this decision is at your provider’s discretion.
  • No specific outcomes or improvements are guaranteed.
  • You will not hold Healthie, your provider, or their associates liable for technical delays or failures.
  • Diagnostic services via the Healthie platform may have limitations that could affect your care.
  • The Healthie platform offers a specific set of telehealth services. You may need to access other resources for additional medical needs.
  • Providers are solely responsible for the quality and appropriateness of your care and act independently without influence from Healthie.
  • Communication via the Healthie platform is not always real-time. You must check the platform regularly for messages.
  • You have the right to discuss telehealth, including alternatives and risks, with your provider.
  • You may withdraw consent at any time without affecting future care eligibility.
  • You have access to your medical records in accordance with applicable laws.
  • You may choose your preferred pharmacy or lab, even if options are suggested through the Healthie platform.
  • Healthie is a third-party beneficiary of this consent and may enforce it.



VI. Additional State-Specific Disclosures


The following disclosures apply to users accessing the Healthie platform for the purposes of participating in a telehealth visit as required by the states listed below:


Iowa

I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: https://medicalboard.iowa.gov/consumers/filing-complaint.


Kentucky

I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: https://kbml.ky.gov/grievances/Pages/default.aspx.


Maine

I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: https://www.maine.gov/md/complaint/file-complaint.


New York

I have been informed that to get information regarding your rights and how to report professional misconduct, I should visit here: https://www.health.ny.gov/professionals/doctors/conduct.


Oregon

I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: https://www.oregon.gov/omb/investigations/pages/how-to-file-a-complaint.aspx.


Rhode Island

I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: https://health.ri.gov/complaints/.


Texas

I have been informed of the following notice:

NOTICE CONCERNING COMPLAINTS- Complaints about physicians, as well as other licensees and registrants of the Texas Medical Board, including physician assistants, acupuncturists, and surgical assistants may be reported for investigation at the following address: Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Assistance in filing a complaint is available by calling the following telephone number: 1-800-201-9353, For more information, please visit our website at www.tmb.state.tx.us.


Vermont

I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: http://www.healthvermont.gov/health-professionals-systems/board-medical-practice/file-complaint; or Board of Osteopathic Examiners can be found at: https://sos.vermont.gov/opr/complaints-conduct-discipline/


Wyoming

I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: http://wyomedboard.wyo.gov/consumers/file-a-complaint.