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filler@godaddy.com
Signed in as:
filler@godaddy.com
By submitting an appointment request form, you agree to the following terms and conditions:
1. Eligibility for Telehealth Services
• You confirm that you are 18 years or older or have parental/guardian consent for minors.
• You must be located in a state where our healthcare providers are licensed to practice at the time of the appointment.
• Telehealth is not appropriate for emergency medical situations. If you have a medical emergency, call 911 or go to the nearest emergency room.
2. Nature of Telehealth Services
• Telehealth involves remote consultations via video, phone, or secure messaging.
• While we strive to provide high-quality care, telehealth has limitations compared to in-person visits, including the inability to perform physical examinations.
• You may be referred for in-person evaluation or additional testing if necessary.
3. Privacy & Confidentiality
• Your medical information is protected under HIPAA (Health Insurance Portability and Accountability Act) and will be kept confidential.
• You agree to participate in telehealth in a private, secure location to maintain confidentiality.
• We use encrypted and secure platforms, but you understand that no system is 100% immune to security risks.
4. Payment & Insurance
• Payment for telehealth services is due at the time of booking, unless prior arrangements are approved. We are a cash-based clinic, and do not accept insurance.
• No refunds will be issued for completed consultations.
5. Cancellations & Rescheduling
• Cancellations or rescheduling require at least 24 hours’ notice to avoid a cancellation fee.
• No-shows may be subject to a missed appointment fee.
• If a provider must cancel, we will notify you and offer to reschedule or issue a refund.
6. Patient Responsibilities
• You agree to provide accurate and complete medical history to ensure safe and effective care.
• You must have a stable internet connection, a working camera (if video is required), and a quiet environment for the consultation.
• If prescriptions are provided, you are responsible for following the provider’s instructions and understanding potential side effects.
7. Consent to Treatment
• By submitting your appointment request form and proceeding with your telehealth appointment, you consent to receive medical care via telehealth.
• You understand that telehealth may not be as comprehensive as an in-person visit and accept any associated limitations.
By submitting this appointment request, you confirm that you have read, understood, and agreed to these terms and conditions.
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