Last updated: this is a template — review with counsel before launch.
What telehealth is
Telehealth means using technology to deliver health care remotely. Your visit may be reviewed asynchronously — meaning a provider reviews your submitted information rather than meeting you live.
What to expect
A licensed provider will review your health questionnaire and may ask follow-up questions before making a treatment decision. They may determine that telehealth is not appropriate for you and recommend in-person care.
Benefits and risks
Benefits include convenience and access. Risks include the possibility that a provider cannot fully assess a condition remotely, technical issues, and that treatment may not be appropriate. By consenting you acknowledge these.
You may withdraw consent to telehealth at any time, though this may affect your ability to use the service.
Prescriptions
If a provider prescribes, your medication is dispensed by a licensed pharmacy. Compounded medications are not FDA-approved and are prepared pursuant to a prescription. You will be told about expected effects and risks.
Your consent
By proceeding with a visit, you consent to receive care via telehealth as described, and you confirm the information you provide is accurate to the best of your knowledge.
This document is a starting template provided as part of a demonstration build. It is not legal advice. Have a qualified healthcare-regulatory attorney review and finalize all legal and consent documents before operating.