Telehealth Informed Consent

1. Nature of Telehealth Services

Telehealth involves the use of electronic communications, technology platforms, messaging, audio, video, and other remote methods to enable healthcare providers to evaluate, diagnose, educate, recommend treatment, prescribe medications when appropriate, and provide healthcare-related services without an in-person visit.

Telehealth services provided through EvermoreMD may include:

• Medical evaluations
• Review of medical history and health information
• Treatment recommendations
• Prescription management, when medically appropriate
• Follow-up care and communications
• Patient education and care coordination

Telehealth services may be provided by physicians, nurse practitioners, physician assistants, or other licensed healthcare professionals authorized to practice in your state.

2. No Guarantee of Treatment or Prescription

Use of EvermoreMD's platform does not guarantee:

• that you will be evaluated by a provider,
• that you are medically appropriate for treatment,
• that a prescription will be written,
• or that any pharmacy will dispense medication.

All medical decisions are made solely at the independent professional judgment and discretion of the licensed healthcare provider.

Providers may determine that:

• telehealth is not appropriate for your condition,
• additional testing or in-person evaluation is necessary,
• or treatment is not medically appropriate.

3. Risks and Limitations of Telehealth

I understand that telehealth services have limitations and potential risks, including but not limited to:

• Delays in evaluation or treatment due to technical failures
• Incomplete or inaccurate transmission of medical information
• Limitations associated with the absence of an in-person physical examination
• Security or privacy breaches despite reasonable safeguards
• Reduced ability to fully assess certain medical conditions remotely
• Potential misunderstandings due to electronic communications

I understand that no results or outcomes can be guaranteed.

4. Alternatives to Telehealth

I understand that alternatives to telehealth services may include:

• In-person office visits
• Urgent care visits
• Emergency room treatment
• Primary care consultations
• Specialist consultations

I understand that I may choose to seek in-person care at any time.

5. Emergency Situations

I understand that EvermoreMD does not provide emergency medical services.

If I believe I am experiencing a medical emergency, I will:

• call 911 immediately,
• contact local emergency services,
• or go to the nearest emergency room.

I understand that telehealth services are not appropriate for emergency conditions.

6. Patient Responsibilities

I acknowledge and agree that I am responsible for:

• Providing accurate, complete, and truthful medical information
• Updating providers regarding medications, allergies, and medical conditions
• Following provider instructions and treatment plans
• Seeking in-person care when advised
• Using the platform in a private and secure environment when possible

I understand that inaccurate or incomplete information may impact diagnosis, treatment recommendations, and patient safety.

7. Privacy and Electronic Communications

I understand that telehealth services involve electronic communications and that my medical information may be transmitted electronically.

EvermoreMD takes reasonable administrative, technical, and physical safeguards to protect patient information; however, no system can guarantee absolute security.

By using the services, I consent to:

• electronic communications,
• electronic medical records,
• email, SMS, or platform-based communications,
• and the electronic transmission of health information as reasonably necessary for treatment, payment, healthcare operations, and related services.

I acknowledge that additional information regarding privacy practices is available in EvermoreMD's Privacy Policy, if applicable.

8. Pharmacy Services

If medication is prescribed, I understand that prescriptions may be transmitted to a licensed pharmacy selected by me, recommended by EvermoreMD, or otherwise designated for fulfillment.

I understand:

• pharmacies independently review and dispense prescriptions,
• pharmacies may decline to fill prescriptions,
• medication availability may vary,
• shipping delays may occur,
• and compounded medications may not be FDA-approved.

I understand that providers and pharmacies maintain independent professional responsibilities and judgment.

9. Compounded Medications and Off-Label Use

I understand that certain medications prescribed through telehealth services may be compounded medications or prescribed for off-label uses where legally permitted.

I acknowledge that:

• compounded medications are not reviewed or approved by the U.S. Food and Drug Administration ("FDA") for safety or effectiveness in the same manner as commercially available FDA-approved drugs,
• individual results may vary,
• and all treatment decisions are based on provider medical judgment and individualized patient needs.

10. Consent to Treatment

By signing or electronically accepting this Consent, I acknowledge that:

• I have read and understand this Telehealth Informed Consent,
• I have had the opportunity to ask questions,
• I understand the risks, benefits, and alternatives to telehealth services,
• and I voluntarily consent to receive healthcare services through EvermoreMD using telehealth technologies.

I understand that I may withdraw my consent for telehealth services at any time by discontinuing use of the services and notifying EvermoreMD, subject to applicable legal and medical record retention obligations.

11. Acknowledgment

By using EvermoreMD's services, I certify that:

• I am at least 18 years old or otherwise legally authorized to consent to treatment,
• I am physically located in a state where the provider is licensed to provide care,
• and I consent to receive telehealth services under the terms described above.

Contact Us

If you have any questions about this Telehealth Informed Consent, please contact us at help@evermoreMD.com.