Telehealth Informed Consent

Effective Date: April 26, 2026  |  Last Updated: April 26, 2026

Please read this document carefully before using telehealth services facilitated through Nuvari. By starting a clinical visit through our Services, you acknowledge that you have read, understood, and voluntarily consent to the terms below.

1. Nature of Telehealth Services

Telehealth involves the delivery of healthcare services using electronic communications, information technology, or other means between a healthcare provider and a patient who are not in the same physical location. Telehealth services facilitated through Nuvari, and provided by our clinical services partner, may include:

• Asynchronous consultations (a provider reviews your health intake and responds without a live visit)
• Synchronous consultations (real-time video or audio communication with a provider)
• Secure messaging between you and your healthcare provider, conducted on the clinical services partner's platform
• Review and evaluation of your health history and symptoms
• Diagnosis and treatment recommendations
• Prescribing of medications when clinically appropriate
• Ongoing monitoring and follow-up care

2. Benefits of Telehealth

Telehealth services may offer the following benefits:

• Improved access to healthcare without the need for in-person visits
• Convenience of receiving care from your home or any private location
• Reduced travel time and associated costs
• Timely access to physician consultations
• Continuity of care through ongoing provider access
• Secure communication, conducted on our clinical services partner's HIPAA-compliant platform

3. Risks and Limitations

As with any medical service, telehealth has potential risks and limitations, including:

• Limited physical examination: Your provider cannot perform a hands-on physical exam. Some conditions may require an in-person evaluation for proper diagnosis or treatment.
• Technology limitations: Technical issues such as poor internet connectivity, equipment failure, or software errors may interrupt or prevent your consultation.
• Information accuracy: The quality of your care depends on the accuracy and completeness of the information you provide. Incomplete or inaccurate information may lead to incorrect diagnosis or treatment.
• Security risks: While we use encryption and security protocols to protect your information, no electronic system is entirely immune to unauthorized access.
• Treatment limitations: Not all conditions are suitable for telehealth treatment. Your provider may determine that an in-person visit is necessary.
• Delayed response: Asynchronous consultations may take up to 24-48 hours for a provider response. This is not appropriate for urgent or emergency medical needs.

4. Emergency Situations

Examples of medical emergencies include, but are not limited to:

• Chest pain or difficulty breathing
• Severe allergic reactions
• Suicidal thoughts or intent to harm yourself or others
• Uncontrolled bleeding
• Loss of consciousness
• Severe adverse reactions to medications

5. Patient Rights

As a telehealth patient, you have the right to:

• Receive information about the provider's qualifications and licensure
• Be informed of all treatment options, including alternatives to telehealth
• Refuse or withdraw your consent to telehealth services at any time
• Request a copy of your medical records
• Expect the same standard of care as an in-person visit
• Have your health information protected in accordance with HIPAA
• Ask questions about the telehealth process at any time
• File a complaint if you are dissatisfied with the care you receive

6. Patient Responsibilities

To receive the best possible care through telehealth, you agree to:

• Provide accurate and complete health information, including current medications, allergies, and medical history
• Inform your provider of any changes to your health status
• Follow your provider's instructions regarding medications and treatment plans
• Participate in your care by asking questions and communicating concerns
• Maintain a stable internet connection and suitable technology for consultations
• Be in a private location during synchronous consultations
• Report any adverse reactions to medications promptly

7. Technology Requirements

To access telehealth services through Nuvari, you will need:

• A device with internet access (computer, tablet, or smartphone)
• A modern web browser (Chrome, Firefox, Safari, or Edge)
• A reliable internet connection
• For video consultations: a working camera and microphone
• A valid email address for account verification and communications

Nuvari is not responsible for technology failures on your end that prevent or disrupt telehealth services.

8. Recording Policy

Telehealth consultations may be recorded for quality assurance and clinical documentation purposes, in compliance with applicable state and federal laws. You will be notified if a session is being recorded and may request that recording be stopped. You agree not to record any telehealth consultation without the express consent of your healthcare provider.

9. Confidentiality

All telehealth communications between you and your healthcare provider are confidential and protected under HIPAA. Health information you share during a clinical visit is collected and protected by our clinical services partner under their HIPAA-compliant infrastructure and Notice of Privacy Practices, presented to you when your clinical visit begins. Nuvari's role is described in our Privacy Policy. Exceptions to confidentiality may include:

• Mandatory reporting requirements (e.g., child or elder abuse)
• Imminent threat of harm to yourself or others
• Court orders or legal subpoenas
• As otherwise required by applicable law

10. Prescriptions

If your provider determines that a prescription medication is appropriate for your condition, the prescription will be sent to a licensed compounding pharmacy for fulfillment. You understand that:

• Not all patients will qualify for prescription medications
• The decision to prescribe is at the sole discretion of your healthcare provider
• Compounded medications are not FDA-approved but are prepared using FDA-approved active ingredients in FDA-regulated facilities
• You must disclose all current medications to avoid potential drug interactions
• You should not take any prescribed medication with alcohol or other substances unless cleared by your provider

11. Fees and Payment

Telehealth consultations are included in the cost of your Nuvari protocol subscription. There are no additional fees for standard provider consultations. If additional services are required that fall outside your subscription, you will be informed of any costs before those services are rendered.

12. Right to Withdraw Consent

You may withdraw your consent to telehealth services at any time, for any reason, without penalty. To withdraw consent:

• Contact us at legal@nuvarihealth.com
• Notify your healthcare provider during any consultation
• Update your preferences in your account settings

Withdrawing consent will not affect any care previously provided. However, it may limit our ability to continue providing telehealth services, and you may need to seek in-person care.

13. State-Specific Requirements

Telehealth regulations vary by state. The availability of specific telehealth services may be limited by your state's laws and regulations. Your healthcare provider is licensed in the state(s) where they practice, and services will be provided in compliance with applicable state telehealth laws.

14. Acknowledgment

15. Contact Us

If you have questions about this Telehealth Informed Consent, please contact us:

Nuvari Health, LLC
Email: legal@nuvarihealth.com
Website: nuvarihealth.com