DRAFT — pending legal review. Telehealth consent requirements vary by state. This document has not been reviewed by counsel. Do not rely on it.

Telehealth Informed Consent

Effective [DATE]  ·  Last updated [DATE]

Please read this before beginning a health review. It explains how care is delivered through OH!, what telehealth can and cannot do, and what you are agreeing to. You will be asked to affirmatively accept it at intake.

1. What telehealth means here

Telehealth is the delivery of health care using communications technology rather than an in-person visit. Care through OH! is primarily asynchronous — you complete a written health questionnaire, and a licensed clinician reviews it and responds through secure messaging. There is generally no live video or phone visit unless your clinician requests one.

Your clinician is licensed in the state where you are located at the time of service. If you move or are temporarily in another state, tell us, because it may affect who can treat you.

2. What you can expect

3. Benefits

4. Risks and limitations — please read carefully

Telehealth is not equivalent to an in-person examination, and you should understand what that means before proceeding.

This is not an emergency service. OH! is not monitored continuously and must never be used to report an emergency. If you experience chest pain, difficulty breathing, severe or prolonged pain, a severe allergic reaction, or any other urgent symptom, call 911 or go to the nearest emergency department immediately.

5. Alternatives

You are not required to use telehealth. You may see a clinician in person, consult your primary care provider, gynecologist, or a specialist in sexual medicine, or seek care through another service. Telehealth is a choice, and declining it will not affect your ability to obtain care elsewhere.

6. A prescription is not guaranteed

Completing an intake and paying for membership does not entitle you to a prescription. Your clinician exercises independent professional judgment and may determine that treatment is unsafe or inappropriate for you. If that happens, we will explain why, and you will not be charged for medication.

7. Your records and your privacy

A medical record of your care is created and maintained as required by the law of your state. You may request a copy at any time. Your health information is handled as described in our Privacy Policy, and is protected under HIPAA once a clinician relationship is established.

Consultations are not recorded as audio or video. Written messages between you and your clinician are retained as part of your medical record.

8. Financial responsibility

Services are provided on a self-pay basis. We do not bill insurance, and services are generally not reimbursable. Costs are disclosed before you are charged. See the Terms of Use for billing and cancellation.

9. Your rights

10. Complaints

Email support@getoh.co. You also have the right to contact the medical licensing board in your state at any time. [INSERT STATE-SPECIFIC BOARD CONTACT DISCLOSURES AS REQUIRED.]

By accepting this consent at intake, you confirm that:

  • You have read and understood this document
  • You are 18 or older and are located in a state where we operate
  • You have had the opportunity to ask questions
  • You understand the risks and limitations of telehealth described in Section 4
  • You understand a prescription is not guaranteed
  • The information you provide will be complete and accurate to the best of your knowledge
  • You consent to receive care through telehealth

Your acceptance is recorded with a timestamp and retained in your medical record.

Questions before you begin? Email support@getoh.co and we will answer before you complete an intake.