Please only use our services after you have read this information and subsequently made an informed decision that we are the right provider for you. If you have any questions, please send us a message through our App or Website or email us at firstname.lastname@example.org.
BACKGROUND ON OUR PLATFORM
M. Hospital is a technology platform that patients to receive and doctors to deliver, both through telemedicine visits and in-person visits. After an initial video conference or in-person visit, physicians will recommend and prescribe treatment when medically appropriate. The consultation allows you to ask any questions and the physician to evaluate whether you are a good candidate for our telehealth model of care.
BOTH A TELEMEDICINE SOLUTION AND IN-PERSON MEDICAL SERVICES
Please note that M. Hospital and [Professional Corporation] provides telemedicine, meaning that we are a digital doctor’s office. In circumstances where the standard of care, convenience, or other issues make an in-person examination and treatment more appropriate, we also provide that option. We are here to fill the gaps in the medical care you receive from other sources.
Please note that M. Hospital is the platform, but is separate and independent from the physicians who deliver care through the platform. We do our best to verify credentials and allow high quality doctors to deliver care for our platform, but are not responsible for the acts or omissions of individual physicians.
NOT A PHARMACY
Please note that we are not a pharmacy. While we may offer the ease and convenience of necessary mail order medications from a trusted source, as a patient, you have the right to choose to obtain a prescription so that you can obtain the medications from a local or independent pharmacy of your choice. Please message or call us and we will be glad to accommodate your wishes. Please note that we do not send prescriptions to pharmacies based outside the United States, and that we reserve the right to charge additional fees to cover the cost of outside pharmacy support services.
NOT FOR EMERGENCIES
We do not provide care on an emergency basis. Please do not use us in a medical emergency. In an emergency, dial 911 or go to a hospital emergency department.
NO DUTY OF CARE PRIOR TO ACCEPTANCE AS A PATIENT
Please note that the doctor only takes responsibility for your care only after you have created an account, answered all the required health-related questions, made payment, had a video consultation, and the doctor has subsequently reviewed your data – and determined that you are a good candidate for telemedicine services who we are accepting as a patient. Please understand that the duty of care does not begin at the earlier points of answering your questions, making payment, or starting a video visit.
RIGHT TO DECLINE PATIENT
Please understand that the doctor has a right to refuse to take responsibility for your care if, in the doctor’s professional judgment, you are not a good candidate for our service. Completing a visit in the App or Website and making payment, starting a video visit, or sending a message through the app do not, by themselves, create a duty of care or a doctor-patient relationship.
NO PROFESSIONAL MEDICAL ADVICE PRIOR TO ACCEPTANCE
Please note that the only content in the App or Website that constitutes professional medical advice is the advice that a doctor provides in a video visit or the personalized messages the doctor sends you after taking responsibility for your care. Any other content is for information purposes only. No other content in the App or Website constitutes professional medical advice. Information in the health questions about who we can and cannot treat does not constitute professional medical advice. Do not disregard professional medical advice or delay in seeking it because of something you have read on our App or Website.
AGREEMENT TO REVIEW ALL CONTENT
AGREEMENT TO ANSWER TRUTHFULLY AND USE OUR PLATFORM HONESTLY
You understand that by, using M. Hospital, you accept the responsibility to provide full and truthful answers to all questions and, when requested, to provide all other data in the most accurate form possible. The doctor relies exclusively upon information that you provide to decide whether or not treatment is safe and appropriate, and, if you provide incorrect information, then you will be at greater risk of adverse events from any treatment that the doctor prescribes and you receive that isn’t necessary, appropriate, or safe. It is important that you don’t create more than one account. Creating more than one account makes it impossible for the doctor to see the full history of care that you’ve received from M. Hospital. This increases the chances that the doctor will not have access to important information and photos in you medical record that could influence the doctor’s clinical decision.
CONSENT TO ACCESS MEDICATION HISTORY
You understand that by using M. Hospital, you are giving explicit consent for the doctor to access medication history, where it’s available, from records provided by pharmacy databases via the services of Surescripts and/or DoseSpot.
BENEFITS AND RISKS OF USING OUR SERVICE
We offer care that is convenient, efficient, and affordable. There are differences between traditional settings of care and M. Hospital’s telehealth platform. In using our App and Website, you accept a greater responsibility to read and understand information throughout the App and Website about the limitations of telemedicine, the risks of seeking care this way, and the risks and benefits of a proposed treatment plan. Specifically, you agree to the following risks:
- NEED TO SEEK OTHER SOURCES OF CARE FOR OTHER MEDICAL NEEDS: You need to seek other sources of care for any other medical needs.
- DELAY: There may be a delay until the next business day before a doctor reviews any request for treatment and reads any messages sent. You must check the App or Website for messages because this is the way that the doctor will communicate important information. Failure to check the App or Website regularly may delay care.
- NO IN-PERSON EXAM: By using our telemedicine platform, you will not have an in-person consultation and physical exam that might identify a medical condition that needs further investigation or immediate treatment.
- CONSENT TO COMMUNICATE VIA UNENCRYPTED EMAIL: Our experience is that the overwhelming majority of M. Hospital patients wish to communicate with us via email, even if unencrypted email does not meet HIPAA standards. In signing this consent, you give us permission to use or disclose your medical information to you via the regular email address you provide to us. You acknowledge that we are communicating in this manner irrespective of HIPAA requirements solely at your direction. You may revoke that permission in writing at any time, in which event we will stop any further use or disclosure of your medical information by email, except to the extent we have already acted in reliance on your permission. You understand that we are unable to take back any disclosure we have already made with your permission and that we are required to retain our records of the communications prior to any revocation of authorization to utilize email in communicating with you.
BENEFITS, ALTERNATIVES AND RISKS OF PARTICULAR TREATMENTS
In the course of providing care for you, we may seek to obtain your informed consent for particular treatment recommendations. For example, in some cases, a physician may recommend a treatment that is “off label,” meaning that the physician is recommending use of a drug or device in a way other than what the drug or device was approved for by the Food and Drug Administration (FDA) , making it an experimental, non-conventional, or alternative form of treatment. When a treatment has a heightened risk, your doctor may provide a specific informed consent to alert you to the risks, benefits, and alternatives of the particular treatment.
IMPORTANCE OF READING ALL THE INFORMATION WE PROVIDE
You understand that M. Hospital will provide detailed information in the App and Website to help you make an informed decision about whether to accept a proposed treatment plan. The most important information about a treatment plan is in the link that the doctor will send when the doctor prescribes a treatment. This information includes detailed information to help you decide if the benefits of the treatment plan outweigh the risks, given the alternative options available to you, which includes the option of not taking any treatment. You understand the importance of reading the information the doctor provides about adverse events, including the signs and symptoms of serious side effects and common side effects from taking a medicine, as this will ensure that you seek appropriate medical attention in a timely manner.
RISKS OF ACCEPTING OUR TREATMENT PLAN
You understand that all the medicines that the doctor may prescribe or recommend, including over-the-counter medicines and ‘behind-the-counter’ medicines, can cause serious side effects and adverse events that include severe allergic reaction, permanent disability, and death. You understand that it is your responsibility to make an informed decision whether to accept a treatment plan that the doctor proposes after weighing the risks and benefits of the medicine being prescribed, alternative treatment options and the risks and benefits of such alternatives, and the option of not seeking any treatment. You understand the importance of reading the manufacturer’s leaflet that comes with a medicine, including an over-the-counter or behind-the-counter medicine, before taking a medicine because this leaflet includes important information about risks and warnings.
You understand that adverse events can be caused by a number of things, including an allergic reaction, side effects, or interactions between a medicine that the doctor prescribes and any medical conditions you may have, other prescription medicines or other things (e.g., supplements, herbs, over-the-counter medicines, or recreational drugs) you are taking, and lifestyle choices such as smoking tobacco products or drinking alcohol.
If you do not understand anything in this Consent or have any other questions, be sure to ask your doctor.
If you go forward with treatment, we will assume that you understood and were able to discuss your questions and concerns with your healthcare provider to your satisfaction.