Telehealth Informed Consent

Purpose

This consent explains telehealth as coordinated through the Velacore platform so you can make an informed decision before proceeding.

Nature of telehealth

Telehealth uses electronic communications to enable a licensed clinician to review your health information and provide care remotely, without an in-person visit. Your care may be based primarily on the information you submit in your online intake. Most reviews are asynchronous, meaning the clinician reviews your intake and responds without a live appointment. A scheduled video visit is available on request at no extra cost, and is required for the first prescription in Arkansas, the District of Columbia, Delaware, Kansas, Mississippi, New Mexico, Rhode Island and West Virginia.

Independent provider relationship

Care is provided by independent, licensed clinicians, physicians and nurse practitioners licensed in your state and engaged through our telehealth services partner, not by Velacore. Velacore coordinates access and logistics and does not practice medicine or make clinical decisions. Clinician availability is 7am to 7pm Central Time; support is available around the clock.

Follow-up care and labs

Ongoing programs include periodic clinician reviews of your intake updates and, where appropriate, laboratory results. For the semaglutide and tirzepatide programs, baseline labs may be ordered through a national laboratory at no cost to you. The clinician may adjust, pause or stop a treatment based on those reviews.

Potential benefits

• Convenient access to a licensed clinician from home.
• Coordinated fulfillment through a licensed 503A compounding pharmacy when prescribed.

Potential risks & limitations

• Without an in-person exam, the clinician relies on the information you provide; incomplete or inaccurate information may affect care.
• A prescription is not guaranteed and is issued only when clinically appropriate.
• Technology failures or delays may occur.
• As with any treatment, medications carry potential risks and side effects.

Your responsibilities

You agree to provide accurate and complete information, follow instructions provided with any treatment, and seek follow-up or in-person care when needed.

Alternatives

You may seek in-person care at any time instead of, or in addition to, telehealth.

Not for emergencies

Telehealth is not for emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room.

Right to withdraw

You may withdraw this consent at any time, which will end the telehealth encounter (without affecting care already provided).

Consent

By proceeding with an online visit, you acknowledge that you have read and understood this consent and voluntarily consent to receive care via telehealth as coordinated through Velacore.

Contact

Email hello@velacorehealth.com.