Telehealth Informed Consent

Last updated: September 29, 2026

This consent explains how telehealth care is delivered through the MyRxProvider platform (the “Platform”). Please read it carefully. When you tick the Telehealth Informed Consent box in the intake and submit it, we record that you agreed, the version of this document and the date and time.

1. What telehealth is

Telehealth is healthcare delivered using electronic communications, including secure questionnaires, messaging, phone and video, between you and a licensed clinician who is not in the same place as you. Through the Platform, an independent clinician licensed in your state may review your health history, diagnose, recommend treatment and prescribe medication where clinically appropriate and legally permitted.

2. How it works on MyRxProvider

1. You complete the online intake. It asks about your weight, health conditions, medications, allergies and safety factors for GLP-1 medications.
2. A licensed clinician in your state reviews your intake, usually within 24–48 hours. They may message you with questions or arrange a phone or video visit before making any decision. Some states require a live visit; if yours does, you will be asked to schedule one.
3. The clinician decides whether treatment is appropriate. They may prescribe, recommend something else, ask for lab work or an in-person exam, or decline to treat you through telehealth.
4. If medication is prescribed, an independent, licensed U.S. pharmacy dispenses it and ships it to you. Your care team stays available for follow-up, dose questions and side effects.

3. Expected benefits

• Access to licensed clinicians without travel or time away from work.
• Timely evaluation, follow-up and medication management.
• Secure electronic communication with your care team.

4. Possible risks and limitations

• Telehealth is not a substitute for in-person care in every situation. A clinician cannot physically examine you, and may decide you need an in-person exam, lab work or a referral.
• The information you provide electronically may not be enough for a clinician to make an appropriate decision, which could delay evaluation or treatment. Incomplete or inaccurate answers increase the risk of harm.
• Although strong security protections are used, including encryption, electronic systems carry some risk of failure or unauthorized access.
• Delays can happen because of technology failures, shipping or scheduling.

5. Not for emergencies

Telehealth services are not appropriate for medical emergencies. If you are having a medical emergency, including chest pain, difficulty breathing, severe abdominal pain, signs of a severe allergic reaction, or thoughts of harming yourself or others, call 911 or go to the nearest emergency room immediately. If you are in crisis, you can also call or text 988.

6. Your responsibilities

• Give accurate, complete and current information about your health, medications and allergies. Clinicians rely on your answers to treat you safely.
• Be physically located in the state you gave in your intake at the time of each telehealth visit.
• Tell your care team about any change in your health, new medications, pregnancy or side effects.
• Keep a relationship with a local primary care provider where possible, and tell them you are receiving care through telehealth.

7. Your rights

• You may refuse or withdraw this consent at any time without affecting your right to future care or any benefits you are otherwise entitled to. Withdrawing consent ends care through the Platform; it does not cancel billing on its own, so also cancel your plan as described in the Terms of Service.
• You have the right to know the name, licensure and credentials of the clinicians treating you, on request.
• You may request a copy of your medical records as described in the Notice of Privacy Practices.
• Other options, including in-person care, are available to you, and you may choose them at any time.

8. Prescriptions

No medication is guaranteed. Prescriptions are issued only in the professional judgment of a licensed clinician after an appropriate evaluation. You may ask for any prescription to be sent to a pharmacy of your choice.

9. Privacy

The laws that protect the confidentiality of your medical information, including HIPAA, apply to telehealth. Your intake is encrypted and stored privately, and it is shared only with your care team, the dispensing pharmacy (an independent, licensed U.S. pharmacy) if you are prescribed medication, and the service providers listed in our Privacy Policy & Notice of Privacy Practices. Your employer never receives your individual health information.

10. Acknowledgment

By ticking the Telehealth Informed Consent box in the intake, you confirm that you are at least 18 years old, that you have read and understood this document, that you have had the chance to ask questions (you can email support@myrxprovider.com at any time), and that you consent to receive healthcare services through the Platform by telehealth.