Telehealth Informed Consent

Last updated: May 15, 2026

1. What telehealth is

"Telehealth" means the delivery of healthcare services using electronic communications instead of an in-person visit. At MaxLife MD, telehealth may include synchronous video or voice visits; asynchronous review of intake forms, photographs, and health questionnaires; secure messaging with your Provider; review of laboratory results; remote monitoring data; and e-prescribing to a partner or local pharmacy.

Information you share during a telehealth encounter — including written history, photographs, lab values, and any data from connected devices — is transmitted electronically to your Provider so they can evaluate, diagnose, treat, and follow up with you.

2. Who provides your care

MaxLife MD ("we," "our," or "us") is a digital health company. MaxLife MD is not a medical practice and does not provide medical advice, diagnosis, or treatment. Healthcare delivered through the platform is provided by independent, licensed physicians, nurse practitioners, and other clinicians (each a "Provider") affiliated with our contracted medical group (the "Medical Group").

Your Provider — not MaxLife MD — makes all clinical decisions about your care. We do not employ, supervise, or direct the medical practice of any Provider. When a Provider treats you, the doctor-patient relationship is between you and that Provider.

3. What we treat (and what we don't)

Our platform is designed for the evaluation and management of certain non-emergency conditions, including (depending on availability and what is appropriate for you) weight management, hormone optimization, metabolic health, peptide therapy, and related wellness services.

We do not provide:

• Emergency or urgent care of any kind;
• Treatment of controlled substances on Schedules I or II;
• Pediatric care (patients must be 18 or older);
• Care for any condition the Provider determines requires in-person evaluation, imaging, or hands-on examination.

A Provider may determine — at any point — that your condition is not appropriate for telehealth and may decline to prescribe, refer you for in-person care, or end the consultation.

4. Potential benefits

• Access to qualified clinicians without leaving home or taking time off work;
• Faster scheduling and reduced travel and wait times;
• Greater privacy for sensitive conditions;
• Easier follow-up and continuity of care through secure messaging;
• Often lower out-of-pocket cost than equivalent in-person visits.

5. Potential risks & limitations

Although MaxLife MD uses industry-standard tools to protect your information and your visit, telehealth carries risks an in-person visit does not. You acknowledge that:

• Technical issues — connectivity, audio, or video failures may interrupt a visit or delay care.
• Limited examination — a Provider cannot physically examine you, take vital signs, or perform hands-on tests during a virtual visit. Some conditions cannot be safely diagnosed or treated this way.
• Information transmission — despite reasonable security measures, electronic transmissions can in rare cases be intercepted, lost, or accessed by unauthorized persons.
• Privacy of your surroundings — anyone in your physical space during a visit may overhear it. Please find a private location.
• State-specific restrictions — your state's laws may limit certain Services, prescriptions, or refill options.
• Diagnostic limits — without certain tests or in-person findings, a Provider may not be able to reach a definitive diagnosis and may refer you for in-person care.

6. Your primary care provider

Telehealth at MaxLife MD is intended to complement, not replace, the care you receive from your primary care physician (PCP) or specialists. You agree to:

• Maintain a relationship with a local PCP for general health and preventive care;
• Inform that PCP and any other treating provider of any treatments, medications, or laboratory results obtained through MaxLife MD;
• Inform your MaxLife MD Provider of any treatments, medications, or test results from other providers.

7. No guarantee of results

No medical service guarantees a specific outcome. By using the Services you acknowledge that results vary, that treatment success depends in part on your adherence, and that adverse effects (including unexpected physical, mental, or emotional effects) are possible. You agree to notify your Provider promptly of any adverse effect or unexpected change in your condition.

A Provider may, in the exercise of professional judgment, recommend an FDA-approved medication or device for a use that differs from the FDA-approved indication ("off-label" use). You have the right to ask questions about, and decline, any recommended treatment.

8. Honest disclosure & safety

Your safety depends on the accuracy and completeness of the information you provide. You agree to:

• Answer all intake and clinical questions honestly and completely;
• Promptly disclose any allergies, prior reactions, prescriptions, supplements, recreational substances, or relevant medical history;
• Notify your Provider immediately of pregnancy, suspected pregnancy, breastfeeding, planned surgeries, or any new diagnosis or medication;
• Keep your contact information current so we can reach you about your care.

9. Referrals & in-person care

If your Provider determines that your condition cannot be safely managed by telehealth, they may refer you for in-person evaluation with your PCP, an emergency department, a specialist, or a local laboratory or imaging center. You are responsible for following up on referrals.

10. Insurance & financial responsibility

MaxLife MD does not currently accept Medicare, Medicaid, Tricare, or commercial insurance. You are financially responsible for all consultation fees, subscription charges, medications, and other Services. We may collect insurance information solely to help you seek reimbursement from your plan directly.

11. Privacy & confidentiality

Your protected health information ("PHI") is handled in accordance with HIPAA, applicable state law, and the Medical Group's Notice of Privacy Practices. MaxLife MD handles non-PHI personal information in accordance with our Privacy Policy. Mandatory exceptions to confidentiality (for example, reporting of suspected child abuse, certain communicable diseases, or imminent threats of harm) apply.

By using the Services, you authorize MaxLife MD, the Medical Group, your Provider, and our partner Pharmacies and Labs to collect, use, and share your information as needed for treatment, payment, and healthcare operations, and as otherwise permitted by law.

12. Your acknowledgments & consent

By accepting this consent, you acknowledge and agree that you:

• Have been given the opportunity to ask questions about telehealth and your alternatives, including in-person care;
• Understand the benefits, risks, and limitations described above;
• Understand that telehealth is not appropriate for emergencies and that you must call 911 or go to an emergency department in an emergency;
• Understand that MaxLife MD is not a medical practice and that your Provider — not MaxLife MD — is responsible for your care;
• Understand that there is no guarantee of results or that any prescription will be issued;
• Will be honest and complete in answering clinical questions and will keep your Provider informed of changes to your health;
• Agree to receive medical information, treatment plans, and follow-up communications electronically;
• Authorize the collection, use, and sharing of your information as described in this consent and our Privacy Policy;
• Agree to hold harmless MaxLife MD and its affiliates, vendors, software providers, the Medical Group, Providers, and Pharmacies in the event that information is compromised or your care is delayed as a result of the failure or breach of any platform technology, except as required by law.

13. Withdrawing consent

You may withdraw this consent at any time by emailing [email protected] with the subject line "Withdraw Telehealth Consent." Withdrawal will end any active subscription Services from the date we process your request, but it will not affect care already delivered or our obligation to keep medical records as required by law. If you begin a new telehealth consultation after withdrawing, your consent will be considered renewed.