Telehealth Informed Consent

Telehealth is the delivery of health care using electronic communication, such as secure video, phone, messages and the review of information and lab results you provide, instead of an in-person visit. Depending on your state’s law and your clinician’s judgment, a visit may be live (video or phone) or asynchronous (your clinician reviews your answers and records, and follows up by message).

Care through Preval Health focuses on cholesterol and related heart-risk prevention in adults, including lab testing, lifestyle guidance and FDA-approved prescription medicines when appropriate.

• Access to care without travel or time away from work.
• Faster follow-up of lab results and medicine changes.
• Ongoing contact with your care team through secure messaging.

• Your clinician cannot examine you in person, so information may be incomplete. Your clinician may ask for more tests or an in-person visit before deciding on treatment.
• Technology can fail, causing delays or loss of information.
• Despite security safeguards, electronic information could be accessed without permission.
• Telehealth may not be right for every condition. Your clinician may decide not to treat you through telehealth and will tell you where to seek care.
• Prescription medicines have side effects. Your clinician will explain the risks of anything prescribed.
• State laws may limit what can be prescribed or how visits must happen.

• you are at least 18 years old and are the person receiving care;
• you will be physically located in a state where care is offered at the time of each visit, and will tell us if that changes;
• the information you provide is true and complete, including medicines, allergies and medical history;
• you understand that Treating Clinicians do not prescribe controlled substances through this service, and that a visit does not guarantee a prescription;
• you will keep a primary care clinician, or seek one, for care outside the scope of this service, and seek in-person care when your clinician advises it;
• you agree to the use of electronic communications for your care, and understand messages are not monitored around the clock;
• you have read the Notice of Privacy Practices, which explains how your health information is used and protected.

• You may decline or withdraw from telehealth care at any time, in writing, without losing the right to future care you are otherwise eligible for.
• You may ask for a live video visit instead of an asynchronous one, and can ask questions before any treatment.
• You may request a copy of your records at any time.
• Your records will not be used to identify you in teaching, research or publications without your separate written permission.

Some states require additional disclosures. If you live in one of these states, your clinician will provide the specific notice during intake. You can file a complaint about a licensed clinician with the medical, nursing or physician assistant board of the state where you received care. Links to every state board are listed by the Federation of State Medical Boards.

Texas residents: Complaints about physicians, as well as other licensees and registrants of the Texas Medical Board, may be reported for investigation at 1801 Congress Ave., Suite 9.200, Austin, Texas 78701, by calling 1-800-201-9353, or at tmb.state.tx.us.

Email support@prevalhealth.com with any questions before you accept.