Telehealth Informed Consent

This Telehealth Informed Consent describes the nature of telehealth services provided through the Baripex platform and the associated benefits, risks, and limitations. Please read it carefully. You will be asked to acknowledge this consent before receiving care.

1. What telehealth is

Telehealth involves the use of secure electronic communications — such as online questionnaires, messaging, and where appropriate audio or video — to enable a licensed healthcare provider to evaluate and, when appropriate, treat you without an in-person visit.

2. Benefits of telehealth

• Access to care from the convenience and privacy of your home.
• Reduced travel and wait times.
• Ongoing, asynchronous communication with your care team.

3. Limitations and risks

• A provider may determine that telehealth is not appropriate for your situation and may recommend an in-person evaluation.
• Because a physical examination is limited or not performed, there is a possibility that a condition could go undetected.
• As with any electronic service, there is a rare risk of technical failure or of a security breach affecting the privacy of your information despite safeguards.
• The accuracy of the evaluation depends on the accuracy and completeness of the information you provide.

4. Your responsibilities

• Provide accurate, complete, and current health information.
• Follow the treatment plan and dosing instructions provided by your clinician.
• Report side effects, new symptoms, or concerns promptly.
• Seek emergency care by calling 911 if you experience a medical emergency.

5. No guarantee of prescription or outcome

You understand that a prescription will be issued only if a licensed provider determines it is clinically appropriate, and that no specific result or outcome is guaranteed. Medications, including compounded medications, carry risks that your provider will discuss with you.

6. Privacy

Information shared during telehealth is protected under applicable privacy laws and our Notice of Privacy Practices and Privacy Policy.

7. Right to withdraw

You may withhold or withdraw this consent at any time without affecting your right to future care or treatment, except that we may be unable to provide telehealth services without it.

8. Consent acknowledgement

By proceeding with an evaluation through Baripex, you acknowledge that you have read and understood this consent, that you have had the opportunity to ask questions, and that you voluntarily consent to receive telehealth services. Questions may be directed to support@baripex.com.