Consent to Treat

Consent is voluntary. You may withdraw at any time. Consent covers evaluation, diagnosis, treatment planning, prescribing, and follow-up care. Consent applies to all providers within the Practice. If the patient is a minor, the parent or authorized guardian provides consent on their behalf.

Treatment may include medical evaluation, nutritional counseling, behavioral health support, medication management (including GLP-1 and anti-obesity medications), lab orders, referrals, and coordination of care. Treatment plans are individualized and may change based on clinical judgment.

Services are delivered via secure audio and video technology. Telehealth is not appropriate for emergencies. You are responsible for ensuring a private, safe environment during sessions. Technical failures may interrupt service; the provider will attempt to reconnect or reschedule. You must provide accurate information about your location during each visit.

Benefits include improved access to care, convenience, reduced travel, and timely follow-up. Risks include technology failures, potential for misdiagnosis due to inability to perform physical examination, unauthorized access to health information, and delays in treatment if technology fails.

All telehealth sessions are conducted using HIPAA-compliant platforms. Health information shared during sessions is protected under HIPAA and applicable state laws. Recordings are not made without explicit consent. Standard limits of confidentiality apply (danger to self/others, suspected abuse, legal requirements).

You are responsible for understanding your insurance benefits. Co-pays, deductibles, and non-covered services are your responsibility. The Practice will submit claims on your behalf when applicable.

You may refuse or withdraw consent at any time without penalty. Withdrawal does not affect your right to future care. If you withdraw, the provider will discuss alternative options.

The Practice may contact you via phone, text, email, or patient portal for appointment reminders, care coordination, lab results, and follow-up. You consent to receive these communications at the contact information provided.

If signing as a parent or guardian, you confirm legal authority to consent on behalf of the minor patient. You agree to inform the Practice of any changes in custody or guardianship.

You may choose any pharmacy for prescriptions. The Practice may recommend specific pharmacies for specialty medications. You consent to the Practice communicating with your chosen pharmacy.

By accepting electronically, you confirm you have read and understood this consent, had the opportunity to ask questions, and voluntarily agree to treatment.

Your electronic signature has the same legal force as a handwritten signature under the E-SIGN Act and applicable state laws.