Telehealth Consent

1. Introduction
Element MD operates a technology platform that connects patients with independent, US-licensed healthcare professionals (“Providers”) through our provider network, Scriptful Inc., and with ScriptfulRX, a licensed compounding pharmacy. This document (“Consent”) provides information about telehealth and the risks and benefits associated with receiving medical care remotely. By using the Element MD platform and seeking care from our affiliated Providers, you consent to receive telehealth services.

2. What is Telehealth?
Telehealth involves the delivery of healthcare services using electronic communications, information technology, or other means between a healthcare provider and a patient who are not in the same physical location. Telehealth may be used for diagnosis, treatment, follow-up, and/or patient education, and may include:

  • Electronic transmission of medical records, photo images, personal health information, or other data between a patient and a healthcare provider.
  • Interactions between a patient and healthcare provider via asynchronous messaging, audio, video, and/or automated questionnaires.

3. Expected Benefits of Telehealth

  • Improved access to medical care by enabling a patient to remain in their preferred location.
  • More efficient medical evaluation and management.
  • Convenient access to prescription fulfillment and direct-to-door delivery.

4. Possible Risks of Telehealth
As with any medical procedure, there are potential risks associated with the use of telehealth. These risks include, but may not be limited to:

  • Information Limitations: The information transmitted may not be sufficient (for example, poor image resolution) to allow for appropriate medical decision-making by the Provider.
  • Lack of Physical Exam: The inability of the Provider to conduct a hands-on physical examination may limit their ability to accurately diagnose or treat your condition.
  • Technology Failures: Delays in medical evaluation or treatment could occur due to deficiencies or failures of the equipment or internet connection.
  • Security Breaches: Although Element MD uses HIPAA-aligned security protocols to protect the confidentiality of patient information, there is always a risk that security protocols could fail, causing a breach of privacy.

5. Your Acknowledgments & Agreements
By accepting this Consent, you acknowledge and agree to the following:

  • Not for Emergencies: You understand that the Element MD platform is NOT intended for medical emergencies. If you are experiencing a medical emergency, you must immediately call 911 or go to the nearest emergency room.
  • Independent Providers: You understand that clinical services are provided by independent medical practitioners, not by Element MD. Element MD solely provides the administrative and technological platform.
  • Compounded Medications: If prescribed, you understand that your medication will be fulfilled by ScriptfulRX, a licensed compounding pharmacy. You acknowledge that compounded drugs are not FDA-approved, meaning the FDA does not evaluate them for safety, effectiveness, or quality, and that they are not generic versions of, or the same as, any FDA-approved drug.
  • Information Sharing: You consent to the sharing of your medical information, intake forms, and treatment records with the affiliated Providers and the dispensing pharmacy for the purpose of care coordination and prescription fulfillment.
  • Right to Withdraw: You have the right to withhold or withdraw your consent to the use of telehealth in the course of your care at any time, without affecting your right to future care or treatment.
  • Primary Care Coordination: You understand that telehealth is not a replacement for primary care. You are strongly encouraged to inform your primary care physician about any telehealth treatments or medications you receive through the Element MD platform.
  • No Guarantees: You understand that medicine is not an exact science, and that no guarantees have been made to you regarding the outcome or results of any treatment or prescription provided through the platform.

6. Patient Consent to Treatment
I have read this document carefully, and my questions have been answered to my satisfaction. I hereby consent to participate in telehealth evaluations and treatments with the independent healthcare providers affiliated with Element MD. I authorize the Providers to medically evaluate, diagnose, and prescribe treatments as they deem clinically appropriate based on my remote consultation.