We provide websites and applications through which you can obtain an online visit with an independent, licensed health care professional (a “Provider”) and mail order pharmacy services for any medications prescribed to you by your Provider (collectively, the “Services”). The Services constitute a form of telehealth, which involves the delivery of health care services using electronic communications between a health care 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. Telehealth may include, but is not limited to:
- Electronic transmission of medical records, photo images, personal health information or other data between a patient and a Provider;
- Interactions between a patient and a Provider via audio, video and/or asynchronous data communications, such as secure messaging and email; and
- Use of data from remote monitoring devices, medical devices, and sound or video files.
The websites, applications, and information systems used in the Services incorporate network and software security protocols to protect the privacy, security, and integrity of your health information. As a patient, you acknowledge and agree to maintain the privacy and confidentiality of your telehealth sessions by conducting them in a private setting and not sharing or recording the sessions without explicit permission from your Provider.
Possible Benefits of Telehealth
- Telehealth can make accessing medical care easier, more efficient, and less expensive.
- You can obtain medical care and treatment at times that are convenient for you. Our telehealth services are available 24 hours a day, 7 days a week via online messaging. Please note that response times may vary, and appointments may be subject to Provider availability.
- You can interact with providers without the necessity of an in-office appointment.
Possible Limitations of Telehealth
- Information transmitted to your Provider may not be sufficient to allow for appropriate medical decision making or your Provider may not be able to provide medical treatment for your condition via telehealth, and you may be required to seek alternative care.
- The inability of your Provider to conduct certain tests or assess vital signs in person may in some cases prevent the Provider from diagnosing or treating you or identifying that you need urgent medical care.
- Your medical care could be delayed due to technological failures that interrupt the Services.
- Data security protocols or safeguards could fail and cause a breach of your identified health information.
- Due to the nature of the Services and regulatory requirements in certain jurisdictions, your treatment options, especially pertaining to certain prescriptions, may be limited.
By checking the “Agree” box you accept this Consent to Telehealth, and you acknowledge your understanding and agreement to the following:
- I have read this Consent to Telehealth carefully, and understand the risks and benefits of the use of telehealth in my medical care and treatment.
- I give my informed consent to receive medical care and treatment by telehealth from Providers affiliated with CMWL. I understand that certain procedures, such as prescribing controlled substances or ordering specific diagnostic tests, may require additional consent forms to be completed separately from this general telehealth consent.
- I understand that the delivery of health care services via telehealth is an evolving field and that the use of telehealth in my medical care and treatment may include uses of technology not specifically described in this consent.
- I understand that while the use of telehealth may provide potential benefits to me, as with any medical care service no such benefits or specific results can be guaranteed. My condition may not be cured or improved, and in some cases, may get worse.
- I understand that I have a duty to answer questions about my health and medical history honestly and accurately, and to keep all of my health care providers, including my Provider, up-to-date on any changes in my health, symptoms, treatments, or medications.
- I understand that withholding or providing inaccurate information about my health and medical history in order to obtain treatment may result in harm to me, including, in some cases, death.
- I understand that my Provider may determine in his or her sole discretion that my condition is not suitable for treatment using telehealth, and that I may need to seek medical care and treatment in person or from an alternative source.
- I understand that the Services enable coordination and communication with a Provider and do not replace my relationship with any existing health care provider.
- I understand that I cannot obtain emergency care through the Services, and I should call 9-1-1 and seek immediate medical treatment if I am experiencing a medical emergency. I acknowledge that my location may be verified at the beginning of each telehealth session to ensure that the Services offered are in accordance with applicable State and Federal laws.
- I understand that my information, including my identified health information, will be collected, used, shared, and protected as described in the Privacy Policy.
- I understand that I have access to all of my health and wellness information pertaining to my telehealth consultation with my Provider in accordance with applicable laws and regulations.
- I understand that CMWL and my Provider will share my telehealth record with my other health care providers only with my consent and at my request. I understand that I can have my telehealth record sent to my other health care providers by emailing virtualcaresupport@cmwl.com and providing my consent along with my health care provider’s name, address, and phone number.
- I understand that a technical failure affecting the Services may result in the loss of my information and/or interrupt my online visit. In addition to any disclaimers that I agreed to by accepting the Terms of Use, I agree to hold CMWL and its affiliated Providers harmless for any loss of information, delay in care, misinterpretation due to lack of physical examination, or other issues inherent to telehealth services resulting from a technical failure or the limitations of remote healthcare delivery. This limitation of liability does not apply to cases of gross negligence or willful misconduct by CMWL or its affiliated Providers.
- In the event of a material breach of this agreement by either party, the non-breaching party may terminate this agreement immediately upon written notice to the breaching party. I understand that I can withhold or withdraw this consent at any time by emailing virtualcaresupport@cmwl.com with such instruction. Otherwise, this consent will be considered renewed upon each new telehealth consultation with a Provider.
- In the event of termination of services within 3 hours of remitting payment, such amounts will be refunded to you. Otherwise, no refunds will be processed or granted.
- I have read and understood the Privacy Policy. I agree and authorize CMWL and my Providers to collect, use, and share my information, including my identified health information and other information regarding the telehealth exam, as described in the Privacy Policy and for any other purposes permitted by law, including for treatment, payment, and health care operations purposes.
All capitalized terms used in this Consent to Telehealth but not defined herein have the meanings assigned to them in the Terms of Use. For avoidance of any doubt, the terms “CMWL“, “we“, “us“, or “our” refer to BE-THIN, Inc dba The Center for Medical Weight Loss (CMWL) and the terms “you” and “yours” refer to the person using the Services.
This agreement shall be governed by and construed in accordance with the laws of the State of Delaware, without regard to its conflict of law provisions. Any legal action or proceeding arising out of or relating to this agreement or the Services shall be brought pursuant to our Terms and Conditions.