Informed Consent to Telehealth

"Telehealth" means the delivery of healthcare services through electronic communications — including secure messaging, video, audio, and the exchange of records and images — between you and a licensed provider who is not in the same physical location as you. Care through Proveta is primarily asynchronous ("store-and-forward"), meaning your intake and messages are reviewed by a provider at a later time rather than in real time.

• Improved access to specialized care without the need to travel.
• Convenience of receiving care from your home at times that work for you.
• Reduced wait times and administrative friction.
• Coordinated follow-up and messaging with your care team.

Telehealth is not a substitute for in-person care in every situation. You should understand the following potential risks and limitations before consenting:

• Information transmitted may be insufficient (for example, poor photo quality) to allow for appropriate medical decision-making.
• A provider cannot perform a physical examination; some conditions may require in-person assessment.
• Technical failures — including delays, disruptions, loss of connection, or breaches of confidentiality despite reasonable security measures — can occur.
• There may be delays in response, particularly for asynchronous messages.
• A different provider may be required to review or follow up on your case depending on clinical need and licensure.

You have the right to decline telehealth and instead seek in-person care with any provider of your choosing. We encourage you to maintain a relationship with a primary care provider to coordinate your overall health.

All telehealth interactions are confidential and protected by HIPAA and applicable state laws. The Medical Group and Proveta implement reasonable safeguards to protect your information. However, electronic communication is not 100% secure, and there is always some risk of unauthorized access despite our efforts. See our Notice of Privacy Practices for details.

• Provide complete, accurate, and truthful information about your medical history, current medications, and symptoms.
• Promptly update your provider about changes in your condition or medications.
• Follow the treatment plan and instructions provided by your physician.
• Notify your provider of side effects or adverse reactions.
• Maintain an in-person relationship with a primary care provider for whole-person care.

You may withdraw your consent to telehealth at any time without affecting your right to seek future care. Withdrawal of consent does not affect care you have already received.

Some states require additional disclosures or attestations for telehealth. Where applicable, those disclosures are presented during your intake or at the time of consent. This document is subject to the laws of the state in which you are located at the time of the telehealth encounter.

By proceeding with your intake assessment and clicking to accept this consent, you acknowledge that you have read this Informed Consent, understand its terms, and agree to receive care through telehealth subject to them.