DOCTORADAM TELEHEALTH CONSENT & OPEN PAYMENTS NOTICE

Informed Consent Regarding Use of Telehealth

Last Updated: December 3, 2024

Purpose

This Consent informs you about telehealth services provided by DoctorAdam and ensures you understand its risks, benefits, and limitations. Services may involve healthcare or mental health professionals such as physicians, nurse practitioners, physician assistants, and licensed mental health professionals (“Providers”) via online platforms operated by DoctorAdam and its subsidiaries.

If the Service is used by or on behalf of a minor (ages 13–18 or the age of majority in your state), this Consent applies to both the minor and their parent or guardian.

Use of Telehealth

Telehealth involves care delivered via electronic means like video, audio, messaging, or electronic transmission of medical records. It is an alternative to in-person care but may not be suitable for all situations. Discuss alternatives with your Provider if needed.

Benefits

• Convenient access to care and treatment.
• Flexible scheduling.
• Improved access to mental health support.

Risks

• Limited diagnostic accuracy due to technology constraints.
• Technology malfunctions (e.g., errors, data corruption).
• Potential breaches of privacy despite security measures.
• Delayed or inadequate treatment due to technical issues.
• Limitations on certain treatments or prescriptions based on regulatory or technological constraints.

Emergencies and Follow-Up

• For emergencies, contact 911 or visit an emergency facility.
• Non-emergency communications can occur via the secure messaging system.

Data Privacy

DoctorAdam employs protocols to safeguard data, but no system is entirely secure. Data sharing occurs only with your consent or as permitted by law for treatment, billing, or other administrative purposes.

Laboratory Services

Some healthcare services require diagnostic testing by third-party labs. Results may include false negatives/positives, potentially affecting diagnosis or treatment accuracy.

Open Payments Notice

For transparency, payments from pharmaceutical or medical device companies to physicians can be accessed via the federal Open Payments database.

Acknowledgments

By agreeing, you consent to:

• Receiving telehealth services from Providers.
• Understanding the risks and limitations of telehealth.
• Accepting that technology and diagnostic tests may not always function optimally.
• Not recording sessions.
• Communicating accurate information to Providers.

You may withdraw your consent by providing written notice, effective upon receipt. DoctorAdam Providers do not offer in-person services; alternative providers must be sought for in-person care.

California Clients

• Physicians and midwives: Contact the Medical Board of California (www.mbc.ca.gov, 800-633-2322).
• Mental health professionals: Contact the California Board of Behavioral Sciences (www.bbs.ca.gov, 916-574-7830).
• For additional questions or concerns, contact DoctorAdam support.