Telehealth Informed Consent

Telehealth refers to the delivery of healthcare services using electronic communications, including internet-based questionnaires, asynchronous messaging, and video consultations. Through our platform, you will interact with an independent licensed physician who will review your medical history, assess your eligibility for treatment, and — if clinically appropriate — issue a prescription that is filled by a licensed US pharmacy.

TeleClinic primarily uses an asynchronous (store-and-forward) telehealth model. You complete a detailed intake questionnaire and provide your medical history. An independent physician reviews your submission at their convenience and responds with a clinical determination — typically within 24–48 hours.

Some states require a synchronous (real-time video) visit before a physician may prescribe. If this applies to you, our platform will notify you and arrange a video consultation prior to prescribing.

Telehealth offers several advantages over traditional in-person care:

— Convenience: consult from home without travel or waiting rooms

— Speed: physician review often completed within 24 hours

— Accessibility: available to patients in underserved areas

— Privacy: discreet, with no requirement to visit a clinic

You understand and accept the following limitations of telehealth care:

— A physician cannot perform a physical examination remotely. Certain conditions may require in-person evaluation that telehealth cannot provide.

— Information transmitted electronically may be intercepted by unauthorized parties, despite reasonable security measures.

— Technical failures (internet outages, software errors) may interrupt or delay your consultation.

— A telehealth consultation through TeleClinic is not a substitute for emergency medical care. If you are experiencing a medical emergency, call 911 or go to your nearest emergency room immediately.

You have the right to:

— Withdraw consent to telehealth services at any time without penalty

— Request an in-person consultation with another provider at any time

— Access your medical records as provided by HIPAA

— Ask questions about your treatment and receive clear answers

— Refuse any recommended treatment without affecting your access to other services

To withdraw this consent, contact support@tele.clinic. Withdrawal of consent will result in termination of your subscription, as telehealth consent is required to use our services.

All communications through our platform are encrypted using industry-standard protocols. Your health information is protected under HIPAA and our Privacy Policy. We do not sell your health information to third parties. See our HIPAA Notice and Notice of Privacy Practices for full details.

By submitting your intake questionnaire and using TeleClinic services, you confirm that: (1) you have read and understood this consent; (2) you have had an opportunity to ask questions; (3) you voluntarily consent to receiving telehealth services through TeleClinic; and (4) you understand the benefits, risks, and limitations described above.

Questions about this consent should be directed to Teleclinic Holdings LLC at support@tele.clinic or (917) 772-9936.