Patient Consent to Telemedicine Care

By creating an account with Telegenix, completing an intake quiz, and accepting a prescription, I provide informed consent to receive medical care via telemedicine. I acknowledge that I have read this consent in full and have had the opportunity to ask questions before submitting it. NATURE OF TELEMEDICINE I understand that telemedicine involves the use of electronic communications — including secure messaging, audio and video conferencing, the exchange of medical records, and the transmission of test results — to enable a physician to evaluate, diagnose, treat, and provide ongoing care without being in the same physical location as me. The physician will rely substantially on the information I provide. RISKS AND LIMITATIONS I understand that telemedicine has limitations compared to in-person care. The physician cannot perform a hands-on physical examination. Findings normally identified through palpation, percussion, or auscultation may go undetected. Technology can fail, and a connection may drop in the middle of a consultation. Information I provide may be incomplete or inaccurate, and that can affect clinical decisions. I understand that no specific outcome can be guaranteed. Medication response varies between individuals. Side effects can occur. I commit to reporting any concerning symptom promptly via the patient portal or, in the event of a medical emergency, by calling 911 or going directly to an emergency room. BENEFITS I understand that telemedicine improves access to physicians I might not otherwise see, reduces travel time, and supports continuity of care through structured follow-up. PRESCRIPTION ACKNOWLEDGMENT I understand that any prescription issued through Telegenix is issued only after a Telegenix physician licensed in my state has reviewed my intake, my medical history, and (where required) my bloodwork, and has determined that the medication is clinically appropriate. I understand that prescriptions may be denied, modified, or revoked at the physician's discretion. I commit to taking medications exactly as prescribed, to following dosing instructions, to disclosing all other medications and supplements I take, and to obtaining the labs my physician requests on the schedule the physician specifies. CONFIDENTIALITY AND PRIVACY I understand that Telegenix protects my health information consistent with HIPAA and the Notice of Privacy Practices. I understand that no electronic system is perfectly secure, and that despite our safeguards there is a small residual risk of unauthorized access to my information. VOLUNTARY PARTICIPATION My consent is voluntary. I may withdraw it at any time by contacting support@telegenix.com, after which Telegenix will discontinue care. Withdrawal does not affect the lawfulness of treatment provided prior to withdrawal. CONFIRMATION By proceeding with checkout, I confirm that I have read this Patient Consent, that I understand its contents, and that I agree to its terms. PLACEHOLDER — this draft is provided for Aftershock QA and client review. Final consent language must be confirmed by Telegenix's counsel before launch.