🌐 Introduction
Telehealth (also known as telemedicine) involves the use of electronic communications to enable healthcare providers at different locations to share individual patient medical information for the purpose of improving patient care. Services at Optimal Clinic USA are provided primarily via telehealth technology.
💻 Nature of Telehealth Consultations
By agreeing to this consent, you acknowledge that you are entering into a provider-patient relationship with a licensed healthcare professional at Optimal Clinic USA via video conferencing, phone, or asynchronous store-and-forward technology.
✅ Benefits and Risks
Benefits:
✔️ Improved access to care
✔️ Convenience
✔️ Reduced travel time
Risks:
⚠️ Technical failures may interrupt the consultation
⚠️ Security protocols could fail, causing a breach of privacy
⚠️ The provider may determine that your condition is not suitable for telehealth and require an in-person evaluation (which we do not provide directly; you would be referred to a local provider)
🛡️ Your Rights and Acknowledgments
🔒 Confidentiality:
I understand that the laws that protect the privacy and confidentiality of medical information also apply to telehealth. No information obtained in the use of telehealth which identifies me will be disclosed to researchers or other entities without my consent.
📱 Technology:
I understand that Optimal Clinic USA uses Tebra and other HIPAA-compliant platforms to conduct video visits. I agree to use a private location and a secure internet connection during my consultation.
🚨 No Emergency Care:
I explicitly understand that Optimal Clinic USA does not provide emergency medical services. If I am experiencing a medical emergency, I will dial 911 immediately.
💊 Prescription Policy:
I understand that the issuance of any prescription (e.g., Testosterone, Peptides, GLP-1s) is at the sole discretion of the provider and is based on medical necessity.
💳 Payment:
I understand that telehealth services are billed as “cash-pay” services and that Optimal Clinic USA does not accept insurance. I agree to be financially responsible for all charges incurred.
📝 Consent
By clicking “I Agree” or signing below, I certify:
✔️ I have read and understand the information provided above regarding telehealth
✔️ I hereby authorize Optimal Clinic USA to use telehealth in the course of my diagnosis and treatment
✔️ I am at least 18 years of age
