This Telehealth Informed Consent was last updated on September 13th, 2024

Telehealth involves the use of secure electronic communications, information technology, or other means to enable a healthcare provider and a patient at different locations to communicate and share individual patient health information for the purpose of rendering clinical care.  This “Telehealth Informed Consent” informs the patient (“patient,” “you,” or “your”) concerning the treatment methods, risks, and limitations of using a telehealth platform. 

Services Provided:

Telehealth services offered by HeyDoctor Medical Group, P.C., HeyDoctor Medical Group (FL), P.A., HeyDoctor Medical Group (NJ), P.C., and HeyDoctor Medical Group (KS), P.A. (collectively, the “Medical Group”), and its employed or contracted providers (collectively, “Engaged Providers”, and, together with the “Medical Group”, the “Providers” or your “Provider”) may include patient consultation, diagnosis, treatment recommendation, prescription, and/or a referral to in-person care, as determined to be clinically appropriate (the “Services”). 

GoodRx Care, LLC does not provide the Services; it performs administrative, payment, and other non-clinical supportive activities for the Providers.

Electronic Transmissions:

The types of electronic transmissions that may occur using the telehealth platform include, but are not limited to:

• Appointment scheduling;
• Completion, exchange, and review of medical intake forms and other clinically relevant information (for example: health records; images; output data from medical devices; sound and video files; diagnostic and/or lab test results) between you and your Provider via:
  • asynchronous communications;
  • two-way interactive audio in combination with store-and-forward communications; and/or
  • two-way interactive audio and video interaction;
• Treatment recommendations by your Provider based upon such review and exchange of clinical information;
• Delivery of a consultation report with a diagnosis, treatment and/or prescription recommendations, as deemed clinically relevant;
• Prescription refill reminders (if applicable); and/or
• Other electronic transmissions for the purpose of rendering clinical care to you.

Expected Benefits:

Telehealth benefits include, but are not limited to, the following:

• Improved access to care by enabling you to remain in your preferred location while your Provider consults with you. Telehealth services rendered by Providers are available seven days a week.
• Convenient access to follow-up care. If you need to receive non-emergent follow-up care related to your treatment, please contact your Provider by logging into your account on https://www.goodrx.com/care/ and sending a message to your Provider through the GoodRx Care message portal (“Message Portal”). 
• More efficient care evaluation and management. 

Service Limitations:

• The primary difference between telehealth and in-person service delivery is the inability to have direct, physical contact with the patient. Accordingly, some clinical needs may not be appropriate for a telehealth visit and your Provider will make that determination.
• Providers do not address medical emergencies. If you believe you are experiencing a medical emergency, you should dial 9-1-1 and/or go to the nearest emergency room. Please do not attempt to contact GoodRx Care, LLC, or your Provider.  After receiving emergency healthcare treatment, you should visit your local primary care provider.
• Providers are an addition to, and not a replacement for, your local primary care provider. Responsibility for your overall medical care should remain with your local primary care provider, if you have one, and we strongly encourage you to locate one if you do not.
• Providers do not have any in-person clinic locations.

Security Measures:

The electronic communication systems we use will incorporate network and software security protocols to protect the confidentiality of patient identification and imaging data and will include measures to safeguard the data and to ensure its integrity against intentional or unintentional corruption.  All the Services delivered to you through telehealth will be delivered over a secure connection that complies with the requirements of the Health Insurance Portability and Accountability Act of 1996.

Possible Risks: 

• Delays in evaluation and treatment could occur due to deficiencies or failures of the equipment and technologies, or provider availability.
• In the event of an inability to communicate as a result of a technological or equipment failure, please contact your Provider via other methods, including by calling (855) 268-2822.
• In rare events, your Provider may determine that the transmitted information is of inadequate quality, thus necessitating a rescheduled telehealth consult or an in-person meeting with your local primary care doctor.
• In very rare events, security protocols could fail, causing a breach of privacy of personal medical information.

Patient Acknowledgments:

By proceeding with your visit, you acknowledge that you understand and agree to the following:

1. As part of your telehealth visit, you have been matched with a provider based on your location, and that you have been (or will be) given your Provider’s credentials.
2. Your Provider will take responsibility for your care only after: (i) you have created an account, answered all the required health questions and provided a photo and/or have had the requisite interaction with your Provider as required by applicable state laws, and made payment; and (ii) Provider has subsequently received your request for treatment and your responses to the aforementioned requested information, reviewed such, and then subsequently determined that you are a good candidate for the telehealth services. You understand that your Provider’s duty of care does not begin at the point of you answering questions or making payment or starting a visit but at the point at which the Provider accepts the duty of care.
3. You understand that making a request for treatment (e.g., by completing a visit on the website and making payment, including providing photos and/or initiating communications with your Provider) or sending a message through the website does not in and of itself create a duty of care or create a practitioner-patient relationship. Your Provider reserves the right to deny care if, in the professional judgment of your Provider, the provision of the telehealth services is not medically or ethically appropriate.
4. If you are experiencing a medical emergency, you will be directed to dial 9-1-1 immediately and your Provider is not able to connect you directly to any local emergency services.
5. You may elect to seek services from a medical group with in-person clinics as an alternative to receiving telehealth services.
6. You have the right to withhold or withdraw your consent to the use of telehealth in the course of your care at any time without affecting your right to future care or treatment.
7. Federal and state law requires health care providers to protect the privacy and the security of health information. You are entitled to all confidentiality protections under applicable federal and state laws.  You understand all medical reports resulting from the telehealth visit are part of your medical record. 
8. Your Provider will take steps to make sure that your health information is only used and disclosed as appropriate. Telehealth may involve electronic communication of your personal health information to other health practitioners who may be located in other areas, including out of state. You consent to your Provider using and disclosing your health information for purposes of your treatment and care coordination, to receive reimbursement for the services provided to you, and for your Provider’s health care operations.
9. Dissemination of any patient identifiable images or information from your telehealth visit to researchers or other educational entities will not occur without your affirmative consent.
10. There is a risk of technical failures during the telehealth visit beyond the control of your Provider. YOU AGREE TO HOLD HARMLESS MEDICAL GROUP AND ITS EMPLOYEES, CONTRACTORS, AGENTS, DIRECTORS, MEMBERS, MANAGERS, SHAREHOLDERS, OFFICERS, REPRESENTATIVES, ASSIGNS, PARENTS, PREDECESSORS, AND SUCCESSORS for any and all delays in evaluation or for information lost due to such technical failures.
11. In choosing to participate in a telehealth visit, you understand that some parts of the Services involving tests (e.g., labs or bloodwork) may be conducted at another location such as a testing facility, at the direction of your Provider.
12. Persons may be present during the telehealth visit other than your Provider in order to operate the telehealth technologies. If another person is present during the telehealth visit, you will be informed of the individual’s presence and his/her role.
13. Your Provider will explain your diagnosis and its evidentiary basis, and the risks and benefits of various treatment options.
14. You have the right to request a copy of your medical records. You can request to obtain or send a copy of your medical records to your primary care or other designated health care provider by contacting your Provider through the chat function, by email at care-legal@goodrx.com, or as otherwise directed by your Provider.
15. Your Provider may charge a reasonable fee for such copy of your medical records (which fee shall include the costs of preparation, shipping and delivery of the medical record). 
16. You must provide your Provider with complete, accurate, and current information regarding your medical history. You understand that you can log into your Message Portal at any time and send a message to access, amend, or review your health information.
17. There is no guarantee that you will be issued a prescription and that the decision of whether a prescription is appropriate will be made in the professional judgment of your Provider. If your Provider issues a prescription, you have the right to select the pharmacy of your choice.
18. There is no guarantee that you will be treated by a Provider. Your Provider reserves the right to deny care for potential misuse of the Services or for any other reason if, in the professional judgment of your Provider, the provision of the Services is not medically or ethically appropriate.

Additional State-Specific Disclosures: The following disclosures apply to patients accessing the Care website for the purposes of participating in a telehealth consultation as required by the states listed below:

Iowa: You have been informed that if you want to register a formal complaint about a provider, you should visit the medical board’s website, here.

Idaho:  You have been informed that if you want to register a formal complaint about a provider, you should visit the medical board’s website, here.

Indiana: You have been informed that if you want to register a formal complaint about a provider, you should visit the medical board’s website, here.

Kentucky: You have been informed that if you want to register a formal complaint about a provider, you should visit the medical board’s website, here.

Maine: You have been informed that if you want to register a formal complaint about a provider, you should visit the medical board’s website, here.

Oklahoma: You have been informed that if you want to register a formal complaint about a provider, you should visit the medical board’s website, here; Or, the Oklahoma Board of Osteopathic Examiners’ website, here.

Rhode Island: You have been informed that if you want to register a formal complaint about a provider, you should visit the medical board’s website, here.

Texas: You 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: You have been informed that if you want to register a formal complaint about a provider, you should visit the medical board’s website, here; Or, the Vermont Board of Osteopathic Examiners’ website, here.