telehealth
Emerge Weight Loss, LLC
Emerge Weight Loss’s Telehealth Consent Agreement
INFORMED CONSENT FOR TELEHEALTH USE
Last Update: September 1, 2024
By selecting “I Agree,” checking a corresponding box, or otherwise indicating your acceptance, you confirm that you have read, understood, and agreed to the terms of this consent. If you do not accept the terms, please refrain from creating an account or using the service. You authorize anyone who clicks “I Agree” on your behalf to accept these terms.
Important: If you are experiencing an emergency, such as having thoughts of suicide, contact 911 or the 988 Suicide & Crisis Lifeline immediately.
PURPOSE
This document explains telehealth and seeks your informed consent for receiving healthcare and/or mental health services from licensed providers such as physicians, nurse practitioners, or mental health professionals through Emerge Weight Loss, LLC’s online platforms (the “Healthcare Service”). The term “you” applies to the service user.
TELEHEALTH SERVICES
Telehealth involves the delivery of healthcare services through technology, where you and your provider are not physically in the same location. This could include the transmission of medical records, photos, personal health data, or real-time interactions through audio or video communications. You are free to seek alternative forms of care, including in-person visits, and can change your preference at any time by discussing options with your provider.
BENEFITS
Telehealth offers several potential benefits, such as easier access to care, the convenience of scheduling, and the ability to engage with your provider without needing an in-person appointment.
RISKS
Telehealth offers several potential benefits in care delivery, but there are also associated risks. These risks include, but are not limited to: limitations in the quality, accuracy, or effectiveness of the care you receive; technological issues such as bugs or errors, which may affect functionality, lead to incorrect outcomes, make systems temporarily inoperable, or cause loss or corruption of data; technology failures may impede your provider’s ability to accurately diagnose or treat your condition; the absence of in-person assessments may restrict your provider’s capacity to diagnose or determine the need for emergency medical intervention; your provider may not be able to treat your condition, requiring you to seek alternative care; mental health therapy could lead to a temporary worsening of symptoms as treatment progresses; delays in evaluation or treatment might occur due to provider unavailability or technical issues; failures in electronic security systems may result in a breach of your personal or medical information; electronic data transmission, such as through emails, could expose your health information to unauthorized third parties; regulatory limitations in certain areas may restrict your provider's diagnostic or treatment capabilities, particularly regarding prescription options; and limited access to your complete medical history may lead to adverse drug interactions, allergic reactions, or other errors in judgment.
EMERGENCY SITUATIONS
If you are experiencing an emergency or urgent medical issue, telehealth may not be appropriate. In these cases, you should seek immediate care at a hospital or urgent care facility. Providers on the service may not be available for immediate response, so in the case of technical issues, you can reach customer support at 1-305-930-7387.
DATA PRIVACY
The service uses security protocols to protect your data and ensure its confidentiality. However, there are no guarantees regarding the absolute privacy of communications, especially when using third-party technology providers. Personal and medical data may be shared as permitted by law for the purposes of treatment, payment, or other healthcare-related functions.
ACKNOWLEDGMENT
By clicking “I Agree” or otherwise accepting this consent, you agree to receive healthcare services through telehealth from the providers available via the service. This consent applies to services provided by healthcare professionals, including physicians, physician assistants, nurse practitioners, and licensed mental health counselors. You also acknowledge the limitations and risks associated with telehealth technology.
You may withdraw your consent for telehealth at any time without affecting your future care. However, Emerge Weight Loss does not offer in-person services, so withdrawing consent may require seeking treatment elsewhere.