What is Telemedicine?

Telemedicine refers to the delivery of health care services—such as evaluations, consultations, diagnoses, and treatment—using electronic communication technologies when you (the patient) are in a different location than your health care provider.

Benefits of Using Telemedicine

Telemedicine offers convenient access to medical care from virtually anywhere with an internet connection, including your home. It reduces the need to visit crowded waiting rooms, helping limit exposure to illness, and often allows for quicker appointments compared to in-person visits. Additionally, telemedicine makes it easier to receive specialized care without the need to travel long distances, especially when such services are not available locally.

Possible Risks of Using Telemedicine

As with any form of medical care, telemedicine involves certain potential risks. These may include, but are not limited to, the following: Delays in medical evaluation, consultation, or treatment may occur due to equipment or internet issues, such as poor video or data quality, connectivity problems, outages, or other service interruptions. If this happens, you may reschedule your appointment with your health care provider. For assistance related to telemedicine equipment or technical difficulties, please contact us at: info@formybodyhealth.com.

There is a possibility that security measures could fail, resulting in a breach of the privacy of your personal health information. Because MyBody Health may not have access to your complete medical history, it is important
that you provide accurate and comprehensive information about your past diagnoses, treatments, medications or supplements, and allergies. Failure to do so may increase the risk of adverse outcomes, including medication interactions, allergic reactions, or ineffective treatment.

Telemedicine services are not intended for emergency situations, and your health information will not be continuously monitored. If you believe you are experiencing a medical emergency, call 911 immediately. All care provided through telemedicine is at the sole discretion of the treating health care provider. There is no guarantee of diagnosis, treatment, or prescription. The provider will determine whether your condition is appropriate for care through telemedicine.

LABORATORY PRODUCTS AND SERVICES 

Certain health care services provided to you through MyBody Health may include laboratory testing. If you are signing this Consent in connection with participating in and receiving specific lab testing services available through the Service (the “Lab Testing Services”), you are doing so as part of a coordinated offering made available through MyBody Health and certain affiliated and/or third-party laboratories. In this arrangement, the Service facilitates access to health care providers who may order laboratory tests and provide related counseling, as determined appropriate by the ordering provider.

As part of the Lab Testing Services, you request and agree to receive ordering services and oversight support from such providers, including but not limited to review of test requests, receipt and interpretation of test results, and related health and wellness counseling. If deemed necessary, a provider may order laboratory blood testing using either an at-home collection kit mailed to you or an in-person visit to a designated blood draw site.

You understand that blood draws carry certain risks, including but not limited to discomfort at the draw site, bruising, redness, swelling, bleeding, lightheadedness, and, in rare cases, infection. These laboratory tests are performed by affiliated and/or third-party laboratories. Neither MyBody Health nor your provider(s) can guarantee the accuracy or reliability of any test results. If you receive laboratory products and/or services through the Service, those products and services are provided by the laboratory, with MyBody Health acting solely as a facilitator between you and the laboratory. Laboratory testing may produce false positive, false negative, or inconclusive results, and test limitations or errors may affect interpretation of your health status and treatment options.

You understand that certain state laws may require a delay before release of test results to allow a provider to review them with you. You acknowledge that you are exercising your right to direct access to your results under applicable federal law and knowingly waive any delay in release, requesting instead that results be provided as soon as they are available. All test results are confidential and will be shared only as necessary among MyBody Health, affiliated providers, and the laboratory processing your sample. Neither MyBody Health nor its providers will disclose your results to any other party without your authorization, except as required or permitted by law. You are responsible for sharing results with your primary care
physician or other health care provider and for seeking appropriate follow-up care, diagnosis, or treatment.

MyBody Health is not a laboratory and is not responsible for storing or retaining your biological specimen after testing. You should contact the testing laboratory directly with any questions regarding specimen retention or disposal. You understand that laboratory testing is voluntary and that you may decline testing at any time. You confirm that you have read and understand this consent, that your questions have been answered, and that the information you provide to MyBody Health is accurate and complete.

You acknowledge that you have had the opportunity to ask questions regarding the purpose of testing, procedures, risks, limitations, results, and your rights before agreeing to this informed consent. 

Your Rights and Acknowledgements 

You acknowledge that providing false, misleading, or incomplete health information may result in improper treatment, delays in care, or potential harm. You are responsible for ensuring that all information you provide—including any statements made under oath—is accurate, complete, and includes all relevant details related to your prescription request, medical history, and current condition. You also confirm that any additional information shared with an Affiliated Provider
through secure messaging, phone, audio, video, or images will be truthful, accurate, and complete. 

You understand that you may decline or discontinue a telehealth visit at any time without affecting your right to future care or treatment and without loss of any benefits to which you are otherwise entitled. You understand that there are no additional or hidden fees associated with telemedicine services.

You understand that your health information may be shared in accordance with the MyBody Health Terms of Service, MyBody Health Privacy Policy, and applicable laws and regulations in your state or territory. 

You also have the right to request that your health information be disclosed to a third party, and such disclosure will be made upon receipt of your signed written authorization. You understand that any sharing of personally identifiable images or information from your telemedicine visit with researchers or other parties will not occur without your explicit written
consent. 

You acknowledge that telemedicine may involve the electronic transmission of your medical information to health care providers located in other states. You retain the same privacy rights during a telemedicine visit as you would during an in-person appointment.

You understand that results cannot be guaranteed. You may not experience the intended benefits of telemedicine services, and your condition may remain the same or worsen despite treatment. 

You acknowledge that prescriptions are not guaranteed and will be issued only if deemed appropriate by the professional judgment of your Affiliated Provider. Your provider may determine that in-person care is necessary, decline to prescribe medication, or refer you to another provider.

FOR CALIFORNIA RESIDENTS: 

You acknowledge receipt of the California Open Payments Database notice. The Open Payments Database is a federal resource used to review payments made by pharmaceutical and medical device companies to physicians and hospitals. 

OPEN PAYMENTS NOTICE
For informational purposes only, a link to the federal Centers for Medicare & Medicaid Services (CMS) Open Payments webpage is provided. The federal Physician Payments Sunshine Act requires that detailed information about payments or other items of value exceeding ten dollars ($10), made by manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals, be disclosed to the public. The database is available at: https://openpaymentsdata.cms.gov

You understand that telehealth is an evolving field, and its uses may expand beyond what is described in this consent.
This Telemedicine Informed Consent remains valid for one (1) year from the date of your initial telemedicine visit. If you wish to withdraw your consent, you must do so before receiving any additional treatment by contacting us at info@formybodyhealth.com. Withdrawing your consent will not affect your right to receive future care or treatment.

Complaints 

To file a complaint against a physician, please contact your state’s medical board. You can find contact information for all U.S. medical boards here: https://www.fsmb.org/contact-a-state-medical-board

Acceptance

By accepting this Consent to Telehealth, you confirm that you have read and understand its contents, including the potential risks, benefits, and your rights. By accepting, you agree to receive medical care via telehealth from Affiliated Providers (as defined in the MyBody Health Privacy Policy) through MyBody Health.