Informed Consent to Telehealth

This document describes what telehealth is, the potential benefits and risks, your rights and responsibilities, and the alternatives available to you when receiving care through Simple MD ("we," "us," or "our"). Before your first visit you will be asked to confirm that you have read and understood this consent.

Placeholder notice. This document is provided as a starting template and must be reviewed by qualified legal counsel and clinical leadership before public reliance. It does not constitute legal or medical advice.

1. What is telehealth?

Telehealth is the delivery of health care services using electronic communications technology — including live video, secure messaging, store-and-forward review of forms and photos, and remote patient monitoring — by a clinician at a different location than the patient. On Simple MD, telehealth may include asynchronous intake review, scheduled video visits, follow-up messaging, e-prescribing, lab ordering, and shipment of prescribed treatments.

2. Expected benefits

• More convenient access to licensed clinicians without travel.
• Faster review of intakes, refills, and follow-up questions.
• Continuity of records across your care team within the platform.
• Greater privacy and flexibility for sensitive health concerns.

3. Risks and limitations

• The clinician cannot perform a hands-on physical examination. Some conditions cannot be safely diagnosed or treated remotely and will require in-person care.
• Technology failures (poor connection, dropped video, device issues) may interrupt the visit or delay care.
• Electronic transmission carries a small risk of interception or unauthorized access, despite encryption and other safeguards.
• Information you provide may be incomplete or inaccurate, which can affect clinical decisions. You are responsible for providing accurate, complete information.
• A prescription, lab order, or treatment may not be issued if the clinician determines it is not clinically appropriate.

4. Not for emergencies

Telehealth is not appropriate for emergencies. If you are experiencing chest pain, difficulty breathing, suicidal thoughts, severe bleeding, or any other medical emergency, call 911 or go to the nearest emergency room immediately.

5. Alternatives

You may choose to receive care from an in-person provider, urgent care, or emergency department instead of using telehealth. Choosing telehealth does not waive your right to seek in-person care at any time.

6. Privacy and records

Visits, messages, and records created through the Services are protected health information and are handled in accordance with HIPAA, state law, and our Privacy Policy. Video visits are not recorded unless you and your clinician both agree. Messages and intake responses are stored in your medical record.

7. Your right to refuse or withdraw consent

Your participation in telehealth is voluntary. You may decline to receive care by telehealth, withdraw this consent, or stop a visit at any time without affecting your right to future in-person care. To withdraw consent, contact support@simple-md.com.

8. Licensing and prescriber discretion

Clinicians providing care through Simple MD are licensed in the states where they practice and exercise their own independent professional judgment. Treatment is available only where permitted by applicable state and federal law.

9. Your acknowledgment

By proceeding with a telehealth visit on Simple MD, you acknowledge that:

• You have read and understood this consent.
• You have had the opportunity to ask questions and have them answered.
• You consent to receive care via telehealth on the terms described above.
• You understand that telehealth has limitations and is not a substitute for emergency care.

10. Contact

Questions about this consent may be sent to support@simple-md.com.