Telehealth Consent

1. Purpose of This Consent

This Telehealth Consent explains the nature, benefits, risks, limitations, and alternatives of receiving healthcare services through telehealth in connection with Elevated Health RX. Elevated provides non-clinical website, intake, checkout, administrative, support, and care-coordination services. Independent licensed clinicians make all clinical decisions. Licensed pharmacy partners, including Epiq Scripts and Rush Pharmacy where available and appropriate, provide pharmacy services.

Intake, secure messaging, records, and patient-portal functions may be supported by Dosable or similar technology vendors.

2. What Telehealth May Include

Telehealth may include one or more of the following:

• Asynchronous intake: You complete health questions, identity/contact information, consent forms, and other screening materials for clinician review.
• Secure messaging: You and the clinician or support team may exchange portal messages about intake, follow-up questions, treatment status, refills, and safety concerns.
• Phone or video visits: A clinician may require or offer a real-time phone or video consultation when clinically or legally appropriate.
• Remote prescription management: A clinician may issue, decline, modify, or discontinue a prescription based on the information available and the clinician's independent judgment.
• Pharmacy coordination: If a prescription is issued, necessary information may be transmitted to a licensed pharmacy for compounding, dispensing, counseling, and shipping.

3. Potential Benefits

• Convenient access to clinician review without visiting a clinic when remote care is appropriate.
• Private intake and portal communications for sensitive anti-aging and longevity concerns.
• Ability for clinicians to review your information asynchronously and request follow-up details when needed.
• Coordination with licensed pharmacies for prescription fulfillment and delivery after a valid prescription is issued.
• Ongoing support for subscription, refill, shipping, and portal access questions.

4. Risks and Limitations

Telehealth has limitations and may not be appropriate for every person or condition.

• No hands-on exam: A remote clinician may not be able to perform a physical examination, collect vital signs, administer injections, perform labs, or observe all symptoms.
• Incomplete information risk: If you omit, misunderstand, or incorrectly enter information, the clinician's evaluation may be incomplete or inaccurate.
• Technology risk: Portal, phone, video, internet, email, or SMS systems can fail, delay messages, or create privacy and security risks despite safeguards.
• Delay risk: Asynchronous review, pharmacy processing, and shipping can create delays compared with in-person care.
• Need for in-person care: A clinician may determine that you need in-person evaluation, labs, imaging, emergency care, or a local primary care or specialist relationship.
• No guaranteed outcome: Telehealth evaluation does not guarantee a prescription, specific medication, dose, symptom improvement, or anti-aging result.

5. Your Responsibilities

• Provide truthful, complete, and current information in intake and all follow-up communications.
• Disclose all medications, supplements, allergies, medical conditions, surgeries, cardiovascular history, cancer history, immune conditions, pregnancy or breastfeeding status, and any other requested information.
• Use the services only for yourself and only while located in a state where the services are available.
• Read all medication labels, pharmacy instructions, storage instructions, and clinician messages before using any medication.
• Promptly report side effects, medication errors, worsening symptoms, missed doses, storage problems, or adverse events to your clinician or pharmacist.
• Maintain a relationship with a primary care clinician and seek in-person care when appropriate.

6. Anti-Aging, NAD+, and Injection-Specific Considerations

Some treatments offered through the Elevated Health RX experience may involve compounded anti-aging or longevity medications, including NAD+ injection therapy when prescribed. These medications may be self-administered or administered outside a clinic. You must follow all instructions from the prescribing clinician and dispensing pharmacy.

• Possible injection-related effects may include redness, warmth, swelling, bruising, soreness, itching, bleeding, infection, dizziness, flushing, chest discomfort, nausea, or allergic reaction.
• Seek urgent care or call 911 for severe allergic reaction, trouble breathing, chest pain, fainting, severe dizziness, severe infection signs, rapidly spreading redness, severe swelling, or any symptom that feels dangerous.
• Do not start treatment if the medication appears damaged, contaminated, incorrectly labeled, expired, frozen when it should not be, warm when cold-chain instructions require refrigeration, or otherwise unsafe. Contact support and the pharmacy.

7. Compounded Medication Disclosure

Some medications may be compounded by a licensed pharmacy for an individual patient after a valid prescription. Compounded medications are not FDA-approved, which means FDA does not review them for safety, effectiveness, or quality before marketing. Compounded medications may be appropriate when a clinician determines that a patient's needs cannot be met by an FDA-approved product or when otherwise permitted by law.

The dispensing pharmacy is responsible for compounding, labeling, dispensing, counseling, and shipping. You should contact the pharmacy or clinician with questions about ingredients, dosing, storage, interactions, contraindications, or adverse effects.

8. Privacy and Information Sharing

You authorize information related to your intake, identity, payment, prescription, pharmacy fulfillment, shipping, support, and treatment to be used and disclosed as needed for treatment, payment, healthcare operations, service operation, safety, legal compliance, and support. This may include disclosure among Elevated, independent clinicians, Dosable-supported portal services, Epiq Scripts, Rush Pharmacy, payment processors, shipping carriers, and other service providers.

Our privacy practices are described in the Privacy Policy and the Notice of Privacy Practices.

9. Communications

You consent to receive telehealth, support, pharmacy, subscription, billing, refill, safety, and shipping communications by portal message, email, phone, text message, mail, or other reasonable methods. Electronic communications may include sensitive information. You are responsible for keeping your contact information current and protecting access to your devices, email, phone, and portal account.

10. Alternatives to Telehealth

You may seek in-person care from a local clinician, clinic, pharmacy, urgent care center, hospital, or other healthcare provider instead of using telehealth. You may also choose not to proceed with evaluation or treatment. If you withdraw from telehealth, it will not affect your ability to seek future care elsewhere.

11. Right to Withhold or Withdraw Consent

Your participation in telehealth is voluntary. You may withhold or withdraw consent by contacting support. Withdrawal will not affect care already provided, prescriptions already issued, pharmacy fulfillment already in progress, records required by law, or disclosures already made in reliance on your consent.

12. Acknowledgments

By using the telehealth services, you acknowledge that:

• You have read and understand this Telehealth Consent.
• Elevated is not a doctor, medical practice, pharmacy, or pharmacist.
• Independent licensed clinicians make all clinical and prescribing decisions.
• Licensed pharmacies dispense and ship prescription medications after receiving a valid prescription.
• Telehealth has benefits, risks, limitations, and alternatives.
• You are responsible for providing accurate and complete information.
• No prescription, medication, dose, refill, or result is guaranteed.
• You will call 911 or seek emergency care for emergencies or dangerous symptoms.
• You consent to telehealth evaluation and related information sharing as described above.

13. Contact