Telehealth Informed Consent

What is Telehealth?

Telehealth involves the delivery of healthcare services using electronic communications — including secure online health intake forms and asynchronous physician review — to facilitate clinical evaluations and prescribing when appropriate.

How MyPause Delivers Telehealth

MyPause uses an asynchronous telehealth model ("store-and-forward"). You complete a detailed health intake form. A licensed physician in your state reviews your information and, if appropriate, issues a prescription. You may exchange messages with your care team through the secure patient portal.

Benefits and Risks

Benefits include convenience, privacy, and access to care without in-person appointments.

Risks include the possibility that your physician may determine that telehealth is insufficient for your situation and that an in-person evaluation is needed. Information transmitted electronically may be delayed. In a medical emergency, telehealth is not appropriate — call 911.

Your Rights

• You have the right to withdraw consent and discontinue telehealth services at any time.
• You have the right to seek in-person care.
• You have the right to access your medical records.
• You have the right to privacy and confidentiality as provided by HIPAA.

Your Responsibilities

• Provide accurate and complete health information.
• Inform your in-person physicians of any telehealth care you receive.
• Seek emergency care (911) for any urgent or life-threatening condition.

Consent

By completing the health evaluation on MyPause, you acknowledge that you have read this Telehealth Informed Consent and agree to receive healthcare services via telehealth as described.

Contact

hola@mypause.health
Leon Ventures, LLC · 17901 Collins Avenue, Sunny Isles Beach, FL 33160