Please read this consent notice carefully before proceeding with your telehealth consultation.

1. Definition of Telehealth

Telehealth involves the use of electronic information and telecommunication technologies (including telephone calls, secure messaging, and remote electronic communications) to enable an UrgentWay healthcare provider to evaluate, diagnose, advise, and treat a patient at a distance.

2. Expected Benefits & Limitations

• Benefits: Convenient, timely access to medical advice and evaluation without traveling to a clinic facility.

• Limitations: A telehealth consultation is conducted remotely without a physical hands-on examination. The healthcare provider relies on the information, symptoms, and medical history you provide during the call.

3. Necessity of In-Person Evaluation or Emergency Care

If during your telephone consultation the provider determines that your condition cannot be safely or accurately evaluated over the phone, or if further diagnostic testing (e.g., X-rays, lab work, physical exams) is required:

• You may be directed to visit an UrgentWay clinic for an in-person evaluation.

• Emergency Situations: Telehealth is not intended for life-threatening emergencies. If you experience severe chest pain, shortness of breath, severe bleeding, or any other emergency, you must immediately call 911 or go to the nearest hospital emergency room.

4. Confidentiality & Security

Your telehealth consultation is confidential. Information disclosed during your call will be documented in your medical record and protected under the Health Insurance Portability and Accountability Act (HIPAA). Staff conduct calls from private clinical areas to protect your privacy.

5. Patient Rights

• You have the right to withhold or withdraw your consent to telehealth care at any time without affecting your right to future care or treatment at UrgentWay.

• You have the right to request an in-person visit instead of a telehealth consultation.

6. Billing & Financial Responsibility

Telehealth services are billed to your health insurance or collected as self-pay fees in accordance with standard clinic pricing and insurance coverage policies. You remain responsible for applicable co-payments, deductibles, or non-covered services.