Florida Telehealth Informed Consent

1. Nature of Telehealth Services

Telehealth is the use of telecommunications and information technology to deliver health care when the patient and clinician are at different locations. The Platform delivers care through two modalities:

• Asynchronous (store-and-forward): you submit information, photographs, intake responses, and laboratory results through the Platform, and a licensed clinician reviews that information at a later time to make clinical decisions.
• Synchronous (live): real-time audio or audio-video visits with a licensed clinician.

The clinician will determine which modality is clinically appropriate for you and may recommend in-person evaluation when necessary.

2. Expected Benefits

• Improved access to licensed clinicians from your home or another private location.
• Reduced travel time and scheduling burden compared with in-person visits.
• Continuity of care through a secure longitudinal record of your encounters.

3. Limitations and Risks

Telehealth has limitations that you should understand before consenting:

• A clinician cannot perform a hands-on physical examination during a telehealth encounter. Some findings that would be detected during an in-person examination may be missed.
• Information that you submit, including photographs and self-reported measurements, may be incomplete, incorrect, or of insufficient quality for clinical decision-making. The clinician may request additional information, decline to proceed, or refer you to in-person care.
• Transmission failures, delays, security events, or equipment issues may disrupt care.
• Electronic storage of health information carries a risk of unauthorized access despite reasonable safeguards.
• In rare cases, telehealth may not provide information sufficient to make an appropriate diagnosis or treatment decision, and delay of in-person care could worsen an underlying condition.

If you are experiencing a medical emergency, do not use the Platform. Call 911 or go to the nearest emergency department.

4. Clinician Licensing and Location

Clinicians who provide care through the Platform are licensed by the Florida Board of Medicine or the Florida Board of Osteopathic Medicine, or are registered as out-of-state telehealth providers as permitted under Florida Statutes section 456.47. You must be physically located in Florida during each telehealth encounter. You agree to disclose your physical location at the time of each encounter when asked.

5. Controlled Substances

Federal law under the Controlled Substances Act, as amended by the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (21 U.S.C. § 829(e)), imposes specific requirements before a controlled substance may be prescribed by means of the internet. Certain medications that may be offered through the Platform, including testosterone (a Schedule III controlled substance) and related therapies, are subject to these requirements and to any applicable federal flexibilities in effect at the time of the encounter. The clinician may require additional steps, including in-person evaluation, laboratory testing, identity verification, or a review of the Florida Prescription Drug Monitoring Program, before a controlled substance is prescribed. Prescribing decisions are made solely by the clinician in the exercise of professional judgment. Not all therapies offered through the Platform are controlled substances. Some peptides and other agents are not federally scheduled and are handled under applicable pharmacy and compounding law.

6. Your Responsibilities

• Provide accurate, current, and complete health and identity information.
• Use a private location, a reliable connection, and a device with functioning audio and video where a synchronous visit is scheduled.
• Follow instructions from the clinician, including instructions for laboratory testing and follow-up.
• Inform the clinician of medications, allergies, other providers, and any pregnancy, suspected pregnancy, or plans to become pregnant.
• Seek in-person care when the clinician recommends it, and seek emergency care when your condition requires it.

7. Recording and Documentation

The clinician will create and retain a medical record that documents the telehealth encounter, including intake responses, clinical notes, laboratory results, and prescriptions, consistent with applicable Florida recordkeeping requirements. We do not record synchronous audio-video visits by default. You may not record any encounter without the express written consent of the clinician. If a specific encounter is recorded, you will be informed at the outset and told how the recording will be stored and used.

8. Alternatives

You have the right to decline telehealth services at any time and to receive care in person from a clinician of your choosing. Declining telehealth will not affect your access to any other rights you may have as a patient.

9. Withdrawal of Consent

You may withdraw this Consent at any time by notifying us in writing at legal@getignite.health. Withdrawal applies to future telehealth encounters and does not affect care already provided. Withdrawal does not entitle you to a refund of fees for services already rendered.

10. Privacy

Information collected during telehealth encounters is handled in accordance with our Privacy Policy and Notice of Privacy Practices. Reasonable administrative, physical, and technical safeguards are used to protect your information, but no electronic system is perfectly secure.

11. Acknowledgment

By submitting an intake, scheduling a visit, or otherwise using telehealth services through the Platform, you acknowledge that you have read this Consent, have had the opportunity to ask questions, understand the nature, benefits, limitations, and risks of telehealth, and voluntarily consent to receive care by telehealth under Florida Statutes section 456.47.