Telehealth Informed Consent

1. What Is Telehealth

Telehealth is the use of electronic communications to enable a licensed provider to review your information and deliver care without an in-person visit. Through Hello You, this typically means completing an online skin assessment that a provider reviews to determine whether treatment is appropriate.

2. Nature of the Service

Care provided through Hello You is asynchronous: you submit information and photographs, and a licensed provider reviews them and responds. You may not interact with the provider in real time. The provider relies on the accuracy and completeness of the information you provide.

3. Potential Benefits

• Convenient access to a licensed provider without an in-person visit.
• Treatment plans tailored to the information you submit.
• Ongoing review and adjustment of your care over time.

4. Potential Risks and Limitations

As with any medical service, telehealth has limitations. Risks may include:

• A provider may be unable to fully assess your condition without an in-person examination.
• Incomplete or inaccurate information may affect the quality of care.
• Technical issues may delay or disrupt communication.
• In rare cases, a condition may not be appropriate for telehealth and may require in-person evaluation.

5. No Guarantee of Outcome

A provider may determine that treatment is not appropriate for you. No specific result or outcome is guaranteed, and individual results vary.

6. Prescriptions

Any prescription is issued solely at the discretion of the reviewing licensed provider and is fulfilled by a partner pharmacy. Prescriptions are issued only when the provider determines treatment is appropriate.

7. Your Responsibilities

• Provide accurate, complete, and current information.
• Follow the guidance and instructions provided with your treatment.
• Inform your provider of any changes in your health, medications, or reactions to treatment.

8. Privacy of Telehealth

Information shared during telehealth is handled in accordance with our Privacy Policy and applicable law, including, where relevant, the Health Insurance Portability and Accountability Act (HIPAA).

9. Emergencies

Telehealth through Hello You is not for emergencies. If you are experiencing a medical emergency, call your local emergency number or go to the nearest emergency room.

10. Right to Withdraw Consent

Your consent to telehealth is voluntary. You may withdraw it at any time without affecting your right to future care, though doing so may end your ability to receive services through Hello You.

11. Acknowledgment and Consent

By using telehealth services through Hello You, you acknowledge that you have read and understood this consent, that your questions have been or can be answered, and that you consent to receive care via telehealth.

12. Contact Us

Questions about this consent can be directed to [contact email] or [company legal entity and mailing address]. These placeholders must be completed before launch.