Telehealth Informed Consent

Document version 2026-07-06.v1. These are the same documents presented for signature before payment.

You are requesting a medical evaluation delivered through telehealth. Telehealth means that your care - including the collection of your health history, the clinical evaluation of your eligibility for treatment, and any follow-up communication - happens through electronic means such as secure forms, secure messaging, telephone, or live video, rather than in a traditional in-person office visit. By signing, you consent to receive this evaluation and any related services through telehealth.

Depending on the state you live in and on your individual answers, your evaluation may be completed asynchronously. This means a licensed clinician may review your written intake, health history, and screening answers and reach a clinical decision without a live video or phone visit, where state law permits this form of evaluation. Your evaluation is performed by a real, licensed clinician in every case - asynchronous review changes how the visit happens, not whether a clinician is involved. If state law requires a live visit, or if the reviewing clinician decides that your situation cannot be safely evaluated from your written answers alone, you will be asked to complete a live video visit before any decision is made. You may also request a live video or phone conversation with a clinician at any point, and one will be arranged before your evaluation is finalized.

Telehealth has limitations. The clinician evaluating you does not perform a hands-on physical examination and relies on the accuracy and completeness of the information you provide. You agree to answer all screening questions truthfully and completely; incomplete or inaccurate answers can lead to unsafe care. Technology can also fail - connections can drop and messages can be delayed. If a technical failure interrupts your visit, we will attempt to re-establish contact and complete your evaluation. The clinician may determine that telehealth is not appropriate for you and may decline to treat you and refer you to in-person care instead. You always have the alternative of seeking an in-person evaluation from a local clinician, and choosing telehealth now does not waive that option.

You can reach your care team at any time through the secure messaging option in your visit status page or through the support contact shown in the site footer. Messages are typically answered within one business day. If your question is about new or worsening symptoms after starting a medication, say so in your message so it can be prioritized for clinical review.

THIS SERVICE IS NOT FOR EMERGENCIES. If you are experiencing a medical emergency - including but not limited to chest pain, trouble breathing, signs of a severe allergic reaction, severe abdominal pain, thoughts of harming yourself or others - call 911 or go to the nearest emergency room immediately. Do not wait for a response through this platform.

Your medical records are created, maintained, and protected in accordance with applicable federal and state law, including confidentiality protections for health information. Information you provide is shared with the clinicians and pharmacy involved in your care and as otherwise permitted or required by law. You have the right to withhold or withdraw this consent at any time before your evaluation is performed; withdrawing consent ends the visit and no evaluation will occur.

GLP-1 & Compounded Medication Treatment Consent

You are requesting an evaluation for treatment with a GLP-1 receptor agonist medication (such as compounded semaglutide) or a GLP-1/GIP receptor agonist (such as compounded tirzepatide) for weight management. This document describes the known risks and important limitations of these medications so that your consent is informed. Signing it does not mean you will be prescribed anything - it means you understand what the treatment involves if a clinician determines it is appropriate for you.

Common side effects. The most common side effects of GLP-1 medications are gastrointestinal: nausea, vomiting, diarrhea, and constipation. Many patients also experience decreased appetite (which is part of how the medication works), stomach discomfort, heartburn, fatigue, headache, dizziness, or mild reactions at the injection site. These effects are usually most noticeable when starting treatment or increasing the dose, and often improve over time. Persistent or severe symptoms should always be reported to your care team.

Serious risks. Less common but serious risks include: inflammation of the pancreas (pancreatitis) - stop the medication and seek medical care immediately if you develop severe, persistent abdominal pain that may radiate to your back, with or without vomiting; gallbladder disease, including gallstones and gallbladder inflammation, which may require surgery; low blood sugar (hypoglycemia), which is significantly more likely if you also take insulin or a sulfonylurea diabetes medication - combining these requires close medical supervision and dose adjustment; and severe gastrointestinal events, including severe vomiting or diarrhea leading to dehydration and kidney injury, and rare reports of slowed stomach emptying (gastroparesis) or intestinal blockage (ileus). Allergic reactions, including rare serious reactions, are also possible. Because these medications slow stomach emptying, tell any surgeon or anesthesiologist that you take a GLP-1 medication before any procedure involving sedation or anesthesia.

BOXED WARNING - THYROID C-CELL TUMORS. In rodent studies, GLP-1 receptor agonists caused thyroid C-cell tumors, including medullary thyroid carcinoma (MTC). It is not known whether these medications cause MTC in humans. Because of this risk, these medications are CONTRAINDICATED - meaning you must not take them - if you or a family member has ever had medullary thyroid carcinoma (MTC), or if you have Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Tell your clinician immediately, and seek evaluation, if you develop a lump or swelling in your neck, hoarseness, trouble swallowing, or shortness of breath while taking this medication.

Compounded medications are not FDA-approved. If treatment is prescribed through this platform, the medication will be a compounded drug prepared by a state-licensed compounding pharmacy. Compounded drugs are permitted under federal law, but they are NOT FDA-approved: the FDA does not review compounded drugs for safety, effectiveness, or quality before they are dispensed. Compounded semaglutide and tirzepatide are not the same products as the FDA-approved brand medications (such as Wegovy, Ozempic, Zepbound, or Mounjaro). The concentration, potency, inactive ingredients, and delivery form of a compounded product can differ from the brand product and can vary between pharmacies and between batches. Doses are not automatically interchangeable unit-for-unit with brand products - follow only the dosing instructions given by your prescribing clinician, and never adjust your dose on your own.

Additional important information. These medications should not be used during pregnancy, while trying to become pregnant, or while breastfeeding; tell your clinician immediately if you become pregnant during treatment. You agree to report new medications, new diagnoses, and significant side effects to your care team, and to stop the medication and seek care for any of the serious warning signs described above. Alternatives to this treatment include lifestyle-only programs, other prescription weight-management medications, FDA-approved brand GLP-1 products, and bariatric procedures - you are free to pursue any of these instead.

Provider Disclosure - Who Performs Your Evaluation

The website or brand through which you reached this visit is a technology and administrative platform. It is not a medical practice, it does not practice medicine, and it does not make clinical decisions about your care. All medical evaluations and all prescribing decisions are made exclusively by independent, state-licensed clinicians. This is true regardless of the brand name, logo, or design you see on this page.

Based on the state you provided during intake, your prospective evaluating provider is the licensed clinician assigned to your case - named to you during checkout, before you sign. If your case must be reassigned for licensing or availability reasons, it will be reassigned only to another clinician licensed in your state, and the final assignment is confirmed and permanently recorded on your visit record before any clinical decision is made about you.

The identity of your evaluating and (if applicable) prescribing clinician is never concealed from you. Their name and credentials appear on your visit record, on any clinical decision communicated to you, and on any prescription that results from your evaluation. If at any time you are unsure who evaluated you, you may request this information through support and it will be provided.

You can independently verify any clinician's license through your state medical board's public license lookup and through the federal NPI Registry (npiregistry.cms.hhs.gov). We encourage you to do so - it is your right as a patient.

The evaluating clinician's duty is to you, the patient, and their clinical judgment is independent. The platform's fee arrangements do not depend on whether your evaluation results in an approval, and no one other than the licensed clinician reviewing your case decides its outcome.