Consent to Telehealth Services

Telehealth means a licensed clinician evaluates and treats you by live, two-way video (or by telephone when video is not possible and the clinician decides it is clinically appropriate) instead of in person. By checking the consent box at booking and joining your visit, you agree to the following.

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   Who treats you. Your visit is with a nurse practitioner, physician assistant or physician licensed in the state where you are physically located at the time of the visit. Your clinician's name and licence information are shown in your visit confirmation and on our Our Providers page.

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   Where you must be. You must be physically located in Arizona, Colorado, Florida, Iowa, New Mexico, Nevada, New York, Utah, Vermont or Washington during the visit, and you will confirm your location at the start. We cannot treat you if you are elsewhere.

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   Identity. We verify who you are. You will be asked to show a government photo ID on camera; for some prescriptions we keep an image of it in your record.

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   What telehealth can and cannot do. Telehealth is suitable for many urgent and primary-care needs. It does not replace a physical examination, imaging or in-person tests. Your clinician may decide that your condition cannot be safely treated by video and will refer you to in-person care; if that happens before treatment begins, your visit fee is refunded in full.

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   Prescriptions are not guaranteed. Your clinician decides whether any medication is appropriate for you. Booking a visit, including a weight-management, hormone or mental-health visit, does not entitle you to a prescription. Some medications cannot be prescribed by telehealth in your state. Prescriptions are sent electronically to the pharmacy you choose.

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   Controlled substances. Schedule II medications are never prescribed. Other controlled medications may be prescribed only after a live video evaluation, identity verification and a check of your state's prescription monitoring program, and only where federal and state law allow.

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   Compounded medications. If a compounded medication is proposed, you will receive a separate written disclosure that it is not FDA-approved and why it is being recommended for you, and you may decline it.

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   Emergencies. Telehealth is not for emergencies. If you have chest pain, trouble breathing, severe bleeding, thoughts of harming yourself or others, or any emergency, call 911 or go to the nearest emergency department.

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   Privacy and security. Visits take place over encrypted video. We do not record visits. Your information is protected under HIPAA and our Notice of Privacy Practices. Technology can fail; if the connection drops, we will call you at the number you gave us to continue or reschedule.

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    Your rights. You may stop the visit at any time, ask who is present with the clinician, and request your records. Withholding consent does not affect your right to future care with us in person where available.

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    Follow-up. You will receive a visit summary, and any prescription or referral, the same day. You may contact us at 725-502-3000 or contact@theoptimalcare.com with questions about your care.

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    Minors. A parent or legal guardian must book and be present for a patient under 18.

I have read this consent, I had the chance to ask questions, and I agree to receive care by telehealth from Optimal Health Primary Care.