Telehealth Informed Consent

1. Purpose of This Consent

This Telehealth Informed Consent ("Consent") describes the nature, benefits, risks, alternatives, and limitations of receiving healthcare services through telehealth via the Daily Slim Downplatform (the "Platform"). It supplements — and does not replace — the informed-consent discussion you will have with your treating provider for any specific treatment.

2. What Telehealth Is

"Telehealth" means the delivery of healthcare services using interactive technologies — including secure messaging, store-and-forward (asynchronous) review of intake forms and photos, and live audio or video — that allow a licensed healthcare provider to evaluate, diagnose, and treat patients remotely. Your provider is licensed in the state where you are physically located at the time of each visit.

3. Voluntary Participation & Right to Withdraw

Telehealth is voluntary. You may withhold or withdraw consent at any time without affecting your right to future care or treatment by other means. If you withdraw consent during a visit, the visit will end and your provider will discuss alternatives.

4. Potential Benefits

• Convenient access to a licensed provider without travel;
• Improved access to care for patients in underserved areas or with mobility limitations;
• Reduced exposure to communicable diseases compared to in-person visits;
• Often shorter wait times; and
• Continuity of care through secure messaging between visits.

5. Potential Risks & Limitations

• Information transmitted may be insufficient to allow your provider to make an appropriate clinical decision (for example, image quality may be inadequate or important findings may not be apparent without an in-person physical exam);
• Delays in evaluation or treatment may occur due to technology problems or scheduling;
• Lack of access to your full medical record from outside providers may affect care;
• Security protocols could fail, causing a breach of your information;
• In rare cases, electronic information could be lost, intercepted, or altered;
• Your provider may determine telehealth is not appropriate for your condition and refer you to in-person care; and
• You may need additional in-person visits, lab work, or imaging that telehealth cannot provide.

6. Alternatives to Telehealth

Alternatives to receiving care via telehealth include in-person evaluation by a healthcare provider, urgent-care visits, or care from your existing primary-care physician. You may pursue any of these alternatives at any time. Your provider will recommend in-person care when telehealth is not clinically appropriate.

7. Emergencies & Urgent Care

Telehealth is not appropriate for medical emergencies. If you are experiencing chest pain, shortness of breath, severe bleeding, suicidal ideation, severe allergic reaction, signs of stroke, severe abdominal pain, or any other condition requiring immediate evaluation, call 911 or go to the nearest emergency department immediately. Do not use the Platform to communicate emergencies.

8. Identity Verification & Eligibility

You must provide your true legal identity, current location (state), date of birth, and accurate medical history. We may use third-party identity-verification services to confirm your identity. Misrepresenting your identity, age, location, or medical history is grounds for termination of services and may constitute insurance or healthcare fraud.

9. State-Licensure Requirements

Healthcare providers may only practice in states where they are licensed. To receive care, you must be physically located in a state where the Platform is operating and your provider is licensed at the time of each visit. If you relocate, notify your provider before your next visit so we can determine whether continuing care is permitted.

10. Prescriptions & Controlled Substances

A prescription is not guaranteed and will be issued only when, in the provider's professional judgment, treatment is medically appropriate, safe, and legal. Your provider may decline to prescribe at any time.

Controlled substances. Federal law (the Ryan Haight Online Pharmacy Consumer Protection Act of 2008) and state laws limit the prescribing of controlled substances via telehealth, generally requiring at least one prior in-person medical evaluation except in narrowly defined circumstances. Our providers comply with these requirements and may decline to prescribe controlled substances entirely.

Compounded medications. Some treatments may be compounded by licensed 503A or 503B compounding pharmacies. Compounded drugs are not FDA-approvedand are not reviewed by the FDA for safety, effectiveness, or quality before being marketed; they are prepared based on a prescription for an individual patient's medical need. Your provider will discuss the risks and benefits with you before prescribing.

11. Recording & Privacy

Audio and video visits are not recorded by default. We will not record any visit without your knowledge and, where required by state law, your consent. Notes and summaries documented by your provider become part of your medical record. Your information is protected as described in our HIPAA Notice of Privacy Practices and Privacy Policy.

You agree not to record any visit without your provider's knowledge and consent.

12. Continuity of Care

We strongly encourage you to maintain a relationship with a primary-care provider. With your authorization, we will share visit summaries, prescriptions, and lab results with your designated primary-care provider for continuity of care.

13. Technology Requirements & Failures

You are responsible for maintaining a compatible device, a stable internet connection, and the latest version of the Platform. If a visit is interrupted by a technology failure, your provider will attempt to reconnect or reschedule. Reasonable accommodations are available — contact [email protected].

14. Acknowledgment

By providing consent, I acknowledge that:

• I have read and understand this Consent and have had the opportunity to ask questions;
• I understand the benefits, risks, limitations, and alternatives to telehealth;
• I understand that telehealth is not for emergencies and I will seek emergency care when appropriate;
• I am at least 18 years old, am physically located in a state where services are offered, and have provided accurate information; and
• I voluntarily consent to receive healthcare services via telehealth from licensed providers through the Platform.

15. Contact

Questions about this Consent:
Support: [email protected]
Mailing address available on request — please email [email protected]