Telehealth Consent & Acknowledgment

Results May Vary

As with any medical treatment or health-related product or service, results may vary from individual to individual. It is important to understand that the outcome of using medications, treatments, or services obtained or facilitated through Healthaide LLC (“Healthaide,” “we,” “us,” or “our”) depends on a range of factors unique to each person. These factors may include, without limitation, personal health status and history, genetic factors, other medications being taken, adherence to treatment instructions, lifestyle, and environmental influences.

Any descriptions of potential benefits, improvements, or expected outcomes associated with medications or treatments are not guarantees, promises, or assurances of specific results. Individual experiences are inherently subjective and may differ from any illustrations, testimonials, or examples you may see in Healthaide’s marketing materials or on its Website.

Before ordering any product or service, including prescription medications, you will be required to complete a medical assessment and may be required to consult with a licensed medical professional within the network of medical groups and/or independent providers (“Providers”) who utilize Healthaide’s technology platform. We encourage you to evaluate your own circumstances carefully and to discuss your medical history and any questions about your treatment options with a qualified Provider before making health-related decisions. We appreciate your understanding of the inherent variability in treatment outcomes and remain committed to transparency, accuracy, and support throughout your experience.

INFORMED CONSENT REGARDING USE OF TELEHEALTH

BY CHECKING A RELATED BOX OR OTHERWISE DIGITALLY SIGNING TO SIGNIFY YOUR ACCEPTANCE OF THIS CONSENT, YOU ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, ACCEPTED, AND AGREED TO BE BOUND BY THIS TELEHEALTH CONSENT & ACKNOWLEDGMENT (“CONSENT”). IF YOU DO NOT AGREE TO THIS CONSENT, DO NOT CREATE AN ACCOUNT AND DO NOT USE THE SERVICE. YOU HEREBY GRANT AUTHORITY TO ANY PARTY WHO CLICKS ON THE “REGISTER ACCOUNT,” “I AGREE,” “PROCEED,” OR SIMILAR BUTTON, OR OTHERWISE INDICATES ACCEPTANCE OF THIS CONSENT ON YOUR BEHALF, TO ACT AS YOUR AGENT FOR SUCH PURPOSE.

IF YOU ARE EXPERIENCING A LIFE-THREATENING SITUATION, INCLUDING BUT NOT LIMITED TO CONTEMPLATING SUICIDE OR SELF-HARM, HAVING CHEST PAIN, DIFFICULTY BREATHING, OR ANY OTHER MEDICAL EMERGENCY, CALL 911 OR THE 988 SUICIDE & CRISIS LIFELINE IMMEDIATELY.

Purpose

The purpose of this Consent is to provide you with information about the use of telehealth and to obtain your informed consent to receive healthcare and/or mental health services using telehealth technologies. Telehealth services may be provided to you by physicians, physician assistants, nurse practitioners, mental health professionals, and other licensed healthcare professionals (collectively, “Providers”) who utilize online platforms, websites, mobile applications, and related technology owned and/or operated by Healthaide LLC and/or its affiliates or subsidiaries (collectively, the “Service”).

In this Consent, the terms “you” and “your” refer to the individual who is accessing or using the Service. If you are using the Service on behalf of an individual minor between thirteen (13) and eighteen (18) years of age (or higher age of majority where required by applicable state law) for whom limited services are permitted, then “you” and “your” shall include both (i) the parent or legal guardian who provides consent to the use of the Service by such minor or uses the Service on behalf of such minor, and (ii) the minor patient for whom consent is being provided.

Provider and Medical Oversight

Healthaide’s clinical services are overseen by our Medical Director and supervising physician:

• Dr. Russell Van Maele, DO

• Medical Director and supervising physician, Healthaide LLC

• Licensed to practice medicine in all 50 U.S. states

• DEA registration active and in good standing

• License numbers are available upon request

• Support contact: support@healthaide.io

Your telehealth care may be delivered by one or more licensed healthcare professionals. Healthaide’s platform is used to coordinate care, but clinical decisions, including whether to prescribe medication, are made by licensed Providers based on clinical judgment and medical necessity.

Prescribing standards and controlled substances

Prescriptions are issued only when clinically appropriate and permitted by law, based on a Provider evaluation and review of your health history and other required information. Prescribing decisions are not made solely based on an online questionnaire.

Testosterone is the only controlled substance that may be prescribed through Healthaide’s services. Testosterone will not be initiated without appropriate clinical evaluation and required laboratory testing. Ongoing therapy requires periodic monitoring, which may include follow-up visits and updated lab work, and refills may be delayed, paused, or discontinued if monitoring requirements are not met.

You agree not to seek early refills, request replacement supplies without a valid reason, or attempt to obtain controlled substances from multiple providers or sources. Requests that fall outside expected prescribing and refill patterns may require additional verification and may be denied.

Dispensing and shipping of medications

Healthaide does not warehouse, stock, or dispense controlled substances. If medication is prescribed, dispensing and shipment are handled by licensed third-party pharmacies.

If you report lost, stolen, or missing medication shipments, you understand that replacement requests may require additional verification and may be denied. Repeated shipment issues, frequent address changes, or other irregular patterns may result in delayed fulfillment or discontinuation of controlled substance prescribing.

How to request licensure information and report concerns

If you would like to request provider licensure details, verify credentials, or report a concern about your care, contact support@healthaide.io.

If you believe you are experiencing a medical emergency, call 911 or go to the nearest emergency room. Telehealth is not appropriate for emergencies.

Use of Telehealth

Telehealth involves the provision of healthcare and/or mental health services using electronic communications, information technology, or other means between a Provider and a patient who are not physically present with each other in the same location. Telehealth may be used for a variety of clinical and non-clinical purposes, including but not limited to evaluation, diagnosis, treatment, follow-up, monitoring, and patient education.

Telehealth interactions may include, but are not limited to, one or more of the following:

• Electronic transmission of medical records, images, photographs, personal health information, or other data between you and a Provider, or between Providers.

• Real-time or asynchronous communications between you and a Provider using audio, video, messaging, chat, or other data communications.
  
  

• Use of output data from medical devices, diagnostic tools, laboratory tests, and monitoring equipment.

• Electronic exchange of information for scheduling, prescription management, care coordination, and other administrative purposes.

Alternative methods of medical care and consultation, such as in-person visits, may be available to you. You may choose an alternative option to telehealth at any time, where such alternative is reasonably available, by discussing this with your Provider. Your Provider may determine that telehealth is not appropriate for some or all of your treatment needs and may advise you to seek care in person or through another appropriate channel.

Patient location and state-specific availability

Telehealth services are available only when you are physically located in a state where the treating Provider is licensed and where telehealth care and prescribing are permitted under applicable state and federal requirements.

You agree to provide accurate information about your physical location when requested during intake and during telehealth encounters. If you are not physically located in an eligible state at the time of care, your Provider may be unable to provide treatment and may be unable to prescribe certain medications.

Anticipated Benefits

The use of telehealth may provide several potential benefits, including but not limited to:

• Making it easier and more efficient for you to access healthcare or mental health services and treatment for conditions that may be treated remotely by your Provider(s).

• Allowing you to obtain certain medical services, consultations, or follow-up care from a Provider at times that may be more convenient for you.

• Enabling you to interact with Providers without the need to travel to a physical office or clinic, which may be helpful if you have mobility or transportation limitations, time constraints, or live in a remote area.

• Supporting continuity of care by facilitating communication between you and your Providers over time.

• For mental health services, telehealth participation may offer opportunities to reduce stress and anxiety, explore and decrease negative thoughts, improve relationships, and increase comfort in various settings, to the extent appropriate and as determined by your mental health Provider.

You understand that the practice of medicine or mental health via telehealth is not guaranteed to produce any particular result or outcome.

Potential Risks

While the use of telehealth can offer advantages, there are also potential risks and limitations. These risks may include, but are not limited to, the following:

• The quality, accuracy, or effectiveness of the services you receive may be limited by the absence of an in-person examination, the inability to perform certain physical tests, or the lack of access to all of your medical records.

• Technology, including the Service and other software or hardware used to provide telehealth, may fail or malfunction (for example, dropped connections, audio/video glitches, software bugs, power outages, system failures, or data transmission errors), which could limit your Provider’s ability to accurately assess your condition, provide a diagnosis, or deliver treatment.

• Limitations on the ability of your Provider to conduct physical examinations or obtain certain vital signs in-person may prevent the Provider from identifying conditions or the need for emergency medical care in some cases.

• Your Provider may determine that your condition is not suitable for evaluation or treatment via telehealth, in which case you may be required to seek alternative care (including in-person or emergency care) for a complete diagnosis or treatment.

• Mental health services may involve discussing information that could be emotionally difficult or distressing, and feelings may temporarily worsen as therapy or counseling progresses, even as longer-term improvement is expected.

• Delays in evaluation, diagnosis, or treatment may occur due to unavailability of Providers, technical problems, or delays in the transmission of information, which may affect your care.

• Electronic systems, security protocols, or safeguards could fail or be inadequate, leading to a potential breach of the privacy or security of your medical or personal information.

• Data transmitted electronically (including via email or other non-encrypted channels) may be more susceptible to unintended disclosure or interception by third parties if such channels are used.

• Due to regulatory requirements in certain jurisdictions, Providers’ ability to prescribe certain medications or therapies may be limited when using telehealth, and such limitations may impact your treatment options.

• A lack of access to complete medical records or information may result in Providers relying on incomplete or outdated information, which could lead to adverse drug interactions, allergic reactions, or other errors in judgment.

By agreeing to receive care via telehealth, you understand and accept these risks and agree that no guarantees have been made to you regarding the outcome of any telehealth consultation or treatment.

Life-Threatening and Other Emergency Situations; Follow-Up Care

If you are experiencing a life-threatening situation, including but not limited to severe chest pain, difficulty breathing, sudden loss of consciousness, severe injury, active suicidal thoughts, or thoughts of harming yourself or others, you must immediately call 911 or go to the nearest emergency room or urgent care facility equipped to handle emergency conditions. You may also call or text the 988 Suicide & Crisis Lifeline at 988 if you are in crisis or contemplating self-harm.

Telehealth is not intended to be used for medical emergencies or urgent situations. Providers using the Service may not be able to respond in real-time or may not be immediately available. Telehealth services provided through Healthaide are not a substitute for emergency or in-person care when needed.

If you are not experiencing an emergency or requiring immediate care, you may communicate with Providers through secure messaging or other supported communication tools available within the Service, subject to the Service’s functionality and Provider availability. You understand that there may be delays in responses, and that for urgent issues you must seek in-person or emergency care as appropriate.

If a technical failure prevents you from communicating with your Providers through the Service, or if you believe there is a problem with the telehealth platform, you should contact Healthaide’s support team at:

Phone: 214-441-6242 (Monday-Friday, 9:00 a.m. – 6:00 p.m. Central Time)

for assistance. However, if the situation appears emergent or urgent, you must call 911 or seek immediate in-person care rather than relying on the Service or attempting to troubleshoot technical issues.

You understand and agree that it is your responsibility to arrange and follow up with any recommended in-person care, laboratory testing, imaging, specialist consultation, or emergency services, as directed by your Provider or as otherwise appropriate for your condition.

Data Privacy and Protection

The electronic systems used to deliver telehealth services through the Service are designed to incorporate network and software security protocols intended to protect the privacy and security of your information and to safeguard data against unauthorized access, alteration, corruption, or loss, whether intentional or unintentional.

Personal information that identifies you and/or includes medical information or protected health information (“PHI”) will not be disclosed to any third party without your consent, except as permitted by law for purposes including, but not limited to, consultation, treatment, payment, billing, healthcare operations, administration, quality improvement, and as required by law (for example, in situations of suspected abuse or neglect, imminent danger to yourself or others, or as otherwise mandated by applicable law). These uses and disclosures may also be described in more detail in your Provider’s Notice of Privacy Practices, which you should review.

You understand and acknowledge that Healthaide may use email or other non-encrypted electronic communications to contact you for certain purposes (for example, appointment reminders, general account communications, or notifications that you have a message waiting in a secure portal). While Healthaide takes reasonable measures to safeguard information, no system is completely secure. Therefore, Healthaide does not and cannot guarantee the security or confidentiality of communications services that you use, including but not limited to your email service provider, text messaging carrier, or Internet service provider. You are responsible for protecting access to your devices, email accounts, and other communication channels you use.

You acknowledge that you have received and had an opportunity to review Healthaide’s Privacy Policy, which describes how your personal information may be collected, used, stored, and disclosed, and that to the extent Healthaide is subject to federal or state privacy laws, it will comply with those laws as applicable.

Prescribing standards and controlled substances

Prescriptions are issued only when clinically appropriate and permitted by law, based on a Provider evaluation and review of your health history, required laboratory testing when applicable, and other required information. Prescribing decisions are not made solely based on an online questionnaire.

Testosterone is the only controlled substance that may be prescribed through Healthaide’s services. Testosterone will not be initiated without appropriate clinical evaluation and required laboratory testing. Ongoing therapy requires periodic monitoring, which may include follow-up visits and updated lab work, and refills may be delayed, paused, or discontinued if monitoring requirements are not met.

To reduce misuse and diversion risk, refill requests outside expected timing, repeated replacement requests, frequent address changes, inconsistent usage reports, or other irregular patterns may require additional verification and may be denied.

Dispensing and shipping of medications

Healthaide does not warehouse, stock, or dispense controlled substances. If medication is prescribed, dispensing and shipment are handled by licensed third-party pharmacies.

If you report lost, stolen, or missing medication shipments, you understand that replacement requests may require additional verification and may be denied. Repeated shipment issues or other irregular patterns may result in delayed fulfillment or discontinuation of controlled substance prescribing.

Laboratory Products and Services

Certain healthcare services provided to you by Providers via the Service may require diagnostic testing, which may include but is not limited to at-home test kits, laboratory testing performed by third-party laboratories, or other diagnostic products and services (“Labs” or “Laboratory Products and Services”). These diagnostic tests, test kits, laboratory analyses, and related services are provided and performed by independent third-party laboratories and not by Healthaide.

Neither Healthaide nor your Providers can guarantee the accuracy, reliability, or completeness of any such Lab tests or results. Laboratory tests may at times produce false negative, false positive, inconclusive, or uncertain results. Such inaccuracies or limitations may impact a Provider’s ability to correctly diagnose or treat your condition and may require additional testing or in-person evaluation.

Failures, defects, or errors in test kits; improper collection, handling, or shipping of specimens; delays in processing; or other problems occurring before, during, or after testing may also impact the quality, accuracy, or reliability of test results. You understand that these risks are inherent in laboratory testing and are not under the direct control of Healthaide.

You acknowledge that any decision by a Provider to rely on laboratory results is made in the Provider’s professional judgment and that you may be advised to undergo repeat or alternative testing or to seek in-person care if results are inconclusive, inconsistent, or otherwise questionable.

Acknowledgment and Consent

By creating an account with Healthaide, by clicking “I Agree,” “I Consent,” “Register,” “Continue,” or any similar button, or by otherwise accessing or using the Service, you acknowledge and agree to the following:

1. You have read this Telehealth Consent & Acknowledgment carefully in its entirety and fully understand its contents, including the potential benefits and risks of receiving healthcare services via telehealth.

2. You understand that telehealth services are not intended to replace in-person care in all situations and that you may be required or advised to seek in-person or emergency medical care where appropriate.

3. You understand that no specific results or outcomes from any diagnosis, treatment, or service provided via telehealth have been promised or guaranteed to you.

4. You understand that Providers using the Service will evaluate whether telehealth is appropriate for your situation and may, in their professional judgment, decline to provide telehealth services or specific treatments, including prescriptions, if they determine such services are not clinically appropriate or safe.

5. You understand that the laws that protect the privacy and security of health and mental health information apply to telehealth in the same way as they do to in-person services, subject to the limitations described in this Consent and in applicable privacy policies and notices.

6. You understand that, despite reasonable efforts to protect your information, there are risks of privacy or security breaches that are associated with any use of electronic systems, and you accept those risks.

7. You acknowledge that you have had an opportunity to ask questions about this Consent and that any questions you may have had have been answered to your satisfaction.

8. You acknowledge that you may withdraw your consent to telehealth services at any time by not scheduling or participating in further telehealth encounters; however, such withdrawal does not affect any actions taken or information disclosed before your withdrawal, and it may impact your ability to receive ongoing care or services via the Service.

BY ACCEPTING THIS CONSENT, YOU ARE CONFIRMING THAT YOU HAVE READ, UNDERSTOOD, AND VOLUNTARILY AGREE TO THE USE OF TELEHEALTH FOR THE DELIVERY OF HEALTHCARE AND/OR MENTAL HEALTH SERVICES THROUGH HEALTHAIDE’S SERVICE, SUBJECT TO THE TERMS, CONDITIONS, RISKS, AND LIMITATIONS DESCRIBED ABOVE.

Licensure requests and concerns

If you would like to request provider licensure details, verify credentials, or report a concern about your care, contact support@healthaide.io