Telehealth Consent

Effective Date: March 15, 2026

BY CLICKING “I AGREE,” CHECKING A RELATED BOX TO SIGNIFY YOUR ACCEPTANCE, OR OTHERWISE AFFIRMATIVELY ACCEPTING THIS CONSENT, YOU ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, AND AGREED TO BE BOUND BY THIS CONSENT. IF YOU DO NOT AGREE, DO NOT USE THE SERVICES.

If you are experiencing a life-threatening emergency, call 911 or the Suicide & Crisis Lifeline at 988.

Purpose

This Telehealth Consent (“Consent”) provides information about receiving healthcare services through telehealth and obtains your informed consent to receive care through Alorah Wellness.

Telehealth services are provided by licensed healthcare professionals, including physicians, nurse practitioners, and physician assistants (“Providers”), through secure online platforms.

Use of Telehealth

Telehealth involves the delivery of healthcare services using electronic communication technologies when the provider and patient are not in the same physical location.

Telehealth services may include:

  • Review of medical history and health information
  • Electronic transmission of medical records, images, and data
  • Communication via secure messaging, audio, or video
  • Treatment recommendations and prescriptions (when appropriate)

You understand that in-person care may be available as an alternative and can be pursued at your discretion.

Potential Benefits

  • Improved access to care
  • Convenience and flexibility
  • Reduced need for in-person visits
  • Faster communication with providers

Potential Risks

While telehealth offers benefits, there are potential risks, including but not limited to:

  • Technology failures or interruptions
  • Limitations in physical examination
  • Delays in care due to technical issues
  • Potential inaccuracies due to incomplete information
  • Privacy or data security risks despite safeguards

You understand that no outcomes or results are guaranteed.

Emergency Situations

Telehealth is not appropriate for emergencies.

If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately.

Providers may not respond immediately to messages submitted through the platform.

Privacy & Data Protection

Alorah Wellness uses secure systems designed to protect your personal and health information in accordance with applicable laws.

Your information may be shared for treatment, payment, and healthcare operations, or as otherwise required by law.

You understand that electronic communications (such as email) may carry some risk of unintended disclosure.

Your Acknowledgment & Consent

By agreeing to this Consent, you acknowledge and understand that:

  • You are receiving healthcare services via telehealth
  • Your Provider may be a physician, nurse practitioner, or physician assistant
  • Telehealth has limitations compared to in-person care
  • Your Provider will determine whether telehealth is appropriate for your condition
  • You may be asked to seek in-person care if necessary
  • You are responsible for providing accurate and complete health information
  • You may withdraw consent at any time by providing written notice

You understand that withdrawing consent may limit your ability to continue using telehealth services through Alorah Wellness.

Prescriptions & Pharmacy

If prescribed, medications may be fulfilled through partner pharmacies and shipped directly to your home.

You are responsible for all costs associated with your care and prescriptions.

Questions or Concerns

For non-medical questions or support needs, please contact us at:

support@alorahwellness.com

For medical or care-related questions, please log into your patient portal to message your provider directly.

If you have concerns about a healthcare provider, you may contact your state’s medical board.