Telehealth Informed Consent

Telehealth is the delivery of health care using secure electronic communications when you and the physician are in different locations. SensibleDoc primarily uses asynchronous ("store-and-forward") care: you submit information and your physician reviews it and responds, rather than meeting in real time. Where a state requires it, your care may instead include a live video or phone visit before any prescription is issued.

• Convenient access to licensed physicians without travel or waiting rooms.
• Timely review of your information and responses, typically within the timeframe described in your membership.
• Care and medications coordinated and shipped to you in one secure place.

• Information you provide may, in rare cases, be insufficient for the physician to make a decision, and the physician may decline to prescribe, request more information, or require an in-person evaluation.
• Technology problems or delays could interrupt or postpone care.
• Despite strong safeguards, no electronic system is perfectly secure, and there is a small risk of a privacy or security breach.
• Without a complete medical record or in-person examination, there is a risk that a condition could go undetected or that information could be incomplete, which could affect care, including the possibility of a drug interaction or adverse reaction.
• Telehealth may not be appropriate for your condition; in-person care may be recommended.

• A licensed physician is responsible for your care; SensibleDoc's software, including AI tools, only assists the care team and does not make treatment decisions.
• No specific result or outcome is guaranteed.
• You may withhold or withdraw this consent at any time without affecting your right to future care, except that withdrawing consent may make it impossible to continue telehealth care.
• You have the right to ask questions, to request an in-person referral, and to know the identity and credentials of your treating physician.
• The same privacy and confidentiality protections that apply to in-person care apply to your telehealth care, as described in our Notice of Privacy Practices.
• It is your responsibility to provide accurate information, to inform us of other providers and medications, and to follow up as instructed, including required labs.

By accepting this consent during intake, you acknowledge that you have read and understand this information, that you have had the opportunity to ask questions, and that you consent to receive care by telehealth through SensibleDoc and its physicians.