TELEHEALTH INFORMED CONSENT

Telehealth involves the delivery of healthcare services using electronic communications, including asynchronous review of health information submitted through online forms. The Provider reviewing your information will evaluate your submitted intake form and health history to determine whether a prescription is appropriate. There is no real-time consultation.

Convenient access to licensed provider review from your home.

No in-person appointments or real-time consultations required.

Fast, discreet, and fully online process.

Telehealth does not replace an in-person relationship with a primary care physician.

Information transmitted electronically may be incomplete compared to an in-person evaluation.

Technical issues may delay or interrupt services.

The Provider may determine that telehealth is not appropriate for your situation and may decline to prescribe.

Your health information is handled in accordance with applicable federal and state privacy laws, including HIPAA where applicable. While we employ reasonable security measures, no electronic transmission is entirely without risk. By using this platform, you acknowledge and accept this inherent limitation.

Any prescription issued through GloWellness is based solely on the clinical judgment of the independent licensed Provider reviewing your case. GloWellness does not influence prescribing decisions. Approval is not guaranteed, and the Provider may request additional information or refer you to an in-person provider.

Your participation in this asynchronous intake review service is entirely voluntary. You may withdraw at any time by ceasing use of the platform. Withdrawal will not affect any care you receive through other providers.

Telehealth services are not appropriate for medical emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately.

By proceeding with the GloWellness intake process, you confirm that: (a) you have read and understood this Consent; (b) you are at least 18 years of age; (c) the information you provide is accurate and complete; and (d) you voluntarily consent to receive telehealth services facilitated through GloWellness by independent licensed providers.

Questions about this Consent? Contact us.