Telehealth consent

This consent explains how care is delivered through telehealth when you start an intake through Vyro Health (New Marketing Vertical LLC) and its partner telehealth platform. Please read it carefully. By starting an intake you confirm that you have read and understood it and that you agree to receive care in this way.

1. What telehealth is

Telehealth is the delivery of healthcare services using electronic communication, such as a written questionnaire, secure messaging, and, where a clinician considers it necessary, a phone or video call. The clinician who treats you may be in a different location from you. The clinician will be licensed to practice in the state you are located in at the time of the consultation.

2. How your care works

• You complete a health intake and provide identification.
• A US-licensed clinician reviews it, may ask follow-up questions by secure message or arrange a call, and decides whether treatment is appropriate. The clinician may decline to prescribe.
• If treatment is prescribed, the prescription is sent to a US-licensed compounding pharmacy, which prepares and ships the medication to you.
• You can message the care team with questions about your treatment, and the clinician may contact you for follow-up.

3. Benefits and limits

Telehealth can make care more accessible, private and convenient. It also has limits. The clinician cannot examine you in person and relies on the information you provide, so incomplete or inaccurate information can lead to a wrong decision. Technology can fail, and delays can occur. In rare cases information could be intercepted despite security measures. If the clinician decides that telehealth is not appropriate for your situation, they will tell you and may recommend in-person care.

4. Your responsibilities

• Provide complete, accurate and current health information and update it if anything changes.
• Read the safety information, follow the dosing instructions on your pharmacy label, and contact the care team or your own doctor if you have questions or side effects.
• Do not share your medication with anyone else.
• Seek emergency care when needed. Telehealth is not for emergencies.

5. Compounded medication

The treatment offered is a compounded medication prepared for you by a licensed pharmacy. Compounded medications are not approved or evaluated for safety, effectiveness, or quality by the FDA. Your clinician will explain the expected benefits and the risks, including side effects and interactions, and you may ask questions before you accept a prescription. Individual results may vary.

6. Emergencies

If you think you are experiencing a medical emergency, call 911 or go to the nearest emergency department. An erection lasting longer than 4 hours, chest pain, sudden vision or hearing loss, and fainting are emergencies. Do not wait for a message reply.

7. Privacy and records

Your health information is protected health information. It is handled under the HIPAA notice of privacy practices and applicable state law, and a medical record of your telehealth care is kept as required by law. You may request a copy of your record.

8. Costs

You are not charged for an intake that a clinician declines. If a prescription is issued, your price is shown before you confirm. Telehealth services and compounded medications are generally not covered by insurance, and we do not bill insurance.

9. Your rights

• You may withhold or withdraw this consent at any time without affecting your right to future care, by stopping the intake or messaging the care team. Withdrawal does not undo care already provided.
• You have the right to ask questions about any aspect of your care and to receive answers you understand.
• You may request that your records be sent to another healthcare provider.
• You may file a complaint with the care team or with the medical board of the state in which your clinician is licensed.

10. State notices

Some states require specific disclosures for telehealth. Where your state requires it, additional notices will be shown to you in the intake before a clinician reviews it.

11. Agreement

By starting an intake you confirm that you are at least 18 years old, that you are the person seeking treatment, that you have read this consent and the privacy policy, and that you consent to receive care by telehealth as described above.