Effective Date: April 30th, 2024
IMPORTANT NOTICE:
OUR PROVIDERS DO NOT ADDRESS MEDICAL EMERGENCIES. DO NOT PROCEED WITH CLINICAL SERVICES USING THE MEDIZENRX PLATFORM IF YOU BELIEVE YOU ARE HAVING A MEDICAL EMERGENCY. IF YOU BELIEVE YOU ARE EXPERIENCING A MEDICAL EMERGENCY, YOU SHOULD DIAL 9-1-1 AND/OR GO TO THE NEAREST EMERGENCY ROOM.
IF YOU ARE CONTEMPLATING SUICIDE, CONTACT 911 OR THE NATIONAL SUICIDE PREVENTION LINE BY ONE OF THE FOLLOWING METHODS:
- DIAL 1-800-273-TALK
- DIAL OR TEXT 988
- Go to 988Lifeline.org to chat LIVE
Introduction
You are reviewing and acknowledging this Telehealth Informed Consent because you are seeking healthcare services utilizing telehealth technologies facilitated through the MediZenRX website, iOS mobile app, web mobile app, or other telehealth technologies collectively the “MediZenRX Platform.” This Telehealth Informed Consent does not modify or supersede any Terms of Use, Privacy Policy, or Notice of Privacy Practices of Wellness Meds LLC or the Providers, rather it supplements these terms and documents.
By creating an account, starting a consult, clicking “I consent to telehealth,” checking a related box to signify your acceptance, or using any other acceptance protocol presented through the MediZenRX Platform, you indicate that you have reviewed the risks as described herein of receiving services utilizing telehealth technologies and consent to receiving the services. A record of this Telehealth Informed Consent is maintained in the files and records of the applicable Provider delivering your services, and your on-going participation in services using telehealth technologies serves as an on-going acknowledgement of your acceptance of this Telehealth Informed Consent.
What is Telehealth?
Telehealth involves the delivery of health and wellness services using electronic communications, information technology, or other means between a licensed, certified, or registered healthcare professional at one location and a patient in another location about a clinical matter. Telehealth may be used for diagnosis, treatment, follow-up and/or patient education. These telehealth services may involve various modalities, including asynchronous interactions, real-time (synchronous) video and audio encounters, and interactive audio with store and forward. This “Telehealth Informed Consent” informs you concerning the treatment methods, risks, and limitations of utilizing telehealth to meet your health and wellness needs.
Benefits and Risks of Telehealth
- Benefits : Telehealth can be more efficient and convenient for accessing health and wellness services. It allows for health services at times that suit you, without needing an in-office appointment.
- Risks : Information transmitted may not be sufficient for proper health services. Technical failures could delay services. In rare cases, incomplete medical records or data quality could result in adverse outcomes.
Consent and Acknowledgments
By accepting this Telehealth Informed Consent, you acknowledge and consent to the following:
- You have reviewed this consent and understand the risks and benefits of using telehealth.
- You understand the privacy risks associated with electronic communication.
- You consent to the involvement of other personnel in the telehealth session as necessary.
- You understand that you may withdraw consent at any time without affecting your right to future care or treatment.
Contact Information
If you have any concerns or require follow-up care, please contact us through the MediZenRX Platform.
State-Specific Disclosures
The following disclosures apply to users accessing the Adonis Health Platform for the purposes of participating in a telehealth visit as required by the states listed below:
Iowa
I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: https://medicalboard.iowa.gov/consumers/filing-complaint .
Kentucky
I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: ttps://kbml.ky.gov/grievances/Pages/default.aspx .
Maine
I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: https://www.maine.gov/md/complaint/file-complaint .
New York
I have been informed that to get information regarding your rights and how to report professional misconduct, I should visit here: https://www.health.ny.gov/professionals/doctors/conduct .
Oregon
I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: https://www.oregon.gov/omb/investigations/pages/how-to-file-a-complaint.aspx .
Rhode Island
I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: https://health.ri.gov/complaints/ .
Texas
I have been informed of the following notice:
NOTICE CONCERNING COMPLAINTS- Complaints about physicians, as well as other licensees and registrants of the Texas Medical Board, including physician assistants, acupuncturists, and surgical assistants may be reported for investigation at the following address: Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Assistance in filing a complaint is available by calling the following telephone number: 1-800-201-9353, For more information, please visit our website at www.tmb.state.tx.us.
AVISO SOBRE LAS QUEJAS- Las quejas sobre médicos, asi como sobre otros profesionales acreditados e inscritos del Consejo Médico de Tejas, incluyendo asistentes de médicos, practicantes de acupuntura y asistentes de cirugia, se pueden presentar en la siguiente dirección para ser investigadas: Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Si necesita ayuda para presentar una queja, llame al: 1-800-201-9353, Para obtener más información, visite nuestro sitio web en www.tmb.state.tx.us
Vermont
I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: http://www.healthvermont.gov/health-professionals-systems/board-medical-practice/file-complaint ; or Board of Osteopathic Examiners can be found at: https://sos.vermont.gov/opr/complaints-conduct-discipline/
Wyoming
I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website, here: http://wyomedboard.wyo.gov/consumers/file-a-complaint .
For further information or to express concerns, please contact:
Wellness Meds LLC, DBA MediZenRX
Email : privacy@medizenrx.com