Telehealth Consent

Telehealth allows Everglow Miami (“Everglow”) and its affiliated medical providers (“Professional Entities”) to evaluate, diagnose, and treat clients remotely using secure technology. This may involve transmitting personal and health information—including medical history, photographs, forms, and intake data—through electronic platforms and audio-video communication systems. These systems use network and software safeguards designed to protect the privacy and security of your information.

1. Purpose, Benefits, and Limitations of Telehealth

Benefits

Telehealth may allow you to:

  • Access licensed healthcare providers without an in-office visit.

  • Receive care at times and locations that are convenient.

  • Connect with clinicians who may not be located in your geographic area.

Limitations and Risks

Telehealth has inherent constraints due to the absence of a physical examination and potential gaps in medical records. Risks may include:

  • Limited clinical information affecting diagnosis or treatment decisions.

  • Possible technical disruptions (poor video/audio quality, internet issues) that delay your consultation or care.

  • Clinical situations that require in-person evaluation and cannot be safely managed through telehealth.

  • In rare cases, security measures may fail and result in unauthorized disclosure of health information.

  • State laws may restrict telehealth services or prescribing in certain jurisdictions.

Telehealth is not appropriate for emergencies.
If you experience severe symptoms, allergic reactions, medication complications, or any medical emergency, call 911 or go to the nearest emergency room immediately.

2. Your Responsibilities as a Client

Accurate and safe care requires accurate and complete information. By participating in Everglow’s telehealth services, you agree to:

  • Provide a full and truthful medical history, including all diagnoses, medications, supplements, allergies, and previous treatments.

  • Update your provider with any changes in your health.

  • Provide accurate demographic and emergency contact information.

  • Understand that withholding information may result in misdiagnosis, inappropriate treatment, or adverse outcomes.

Your provider may decline to prescribe medication, request additional information, or refer you for in-person evaluation if telehealth is not sufficient for safe care.

3. Provider Qualifications and Scope of Care

  • Healthcare services at Everglow may be provided by licensed nurse practitioners or physician assistants. You consent to receiving care from these licensed non-physician providers.

  • Telehealth technologies used by Everglow may evolve and may differ from the examples described here.

  • No clinical outcome—including medication response or laboratory findings—is guaranteed.

  • Some conditions cannot be safely or effectively treated through telehealth and may require in-person medical evaluation.

Your provider will determine, in their professional judgment, whether telehealth is appropriate for your situation.

4. Communication, Privacy, and Confidentiality

  • Telehealth involves electronic communication of personal and medical information.

  • All information will be handled according to Everglow’s Privacy Policy and applicable HIPAA requirements.

  • Everglow maintains administrative, technical, and physical safeguards to protect data integrity and confidentiality.

  • Despite strong protections, electronic systems carry inherent privacy risks that cannot be entirely eliminated.

Online consultations will not be recorded.

5. Financial Considerations and Prescribing

  • You may choose to seek evaluation or treatment from other medical providers at any time.

  • When clinically appropriate, prescriptions will be issued by Everglow’s licensed medical providers and fulfilled by partner compounding pharmacies.

  • Medications will be shipped directly to the address you provide.

  • You are responsible for all charges associated with your services and prescriptions.

  • You acknowledge that services obtained through Everglow are not billed to Medicare or insurance, and you will not seek reimbursement from Medicare.

6. Consent, Withdrawal, and Ongoing Use

  • You acknowledge that you have reviewed the benefits, risks, and alternatives to telehealth.

  • You consent to receiving care through telehealth as part of your treatment with Everglow Miami.

  • You may withdraw your consent at any time by providing written notice. Withdrawal does not affect actions taken before your notice was received.

  • Your continued use of Everglow’s services constitutes ongoing consent to telehealth treatment.

Acknowledgment

By proceeding with Everglow Miami’s services, you confirm that you understand and accept the terms of this Telehealth Consent, and you authorize Everglow and its affiliated medical providers to deliver care via telehealth.