Medical Consent

Last updated: January 1, 2024 (v 1.0.0)

Telehealth Consent

Telehealth is the type of care that allows clients to access health services using audio-video interface such as videoconferencing.

Possible benefits include:

  • Improved access to weight loss management health care by enabling a client to receive services across distances and between programs.
  • More efficient weight loss management health care including medical evaluation and management.
  • Obtaining expertise of a distant specialist.

Possible risks include:

  • In rare cases, information transmitted may not be sufficient to allow for appropriate medical decision making.
  • Delays in medical evaluation and treatment could occur due to deficiencies or failures of the equipment.
  • In very rare instances, security protocols could fail, causing a breach of privacy of personal medical information.

I understand that:

  • I understand that the laws that protect privacy and confidentiality of medical information also apply to telehealth.
  • I understand that I have the right to withhold or withdraw my consent to the use of telehealth at any time.
  • I understand that I have the right to inspect all information obtained in the course of a telehealth interaction.

My continued use of the services constitutes my understanding and acceptance of the above terms and I authorize the use of telehealth in the course of my diagnosis and treatment.

HIPAA Notice

HIPAA provides safeguards to protect your privacy. Patient information will be kept confidential except as necessary to provide services.

It is the policy of this office to remind patients of their appointments via telephone, e-mail, or U.S. mail.

Your confidential information will not be used for the purposes of marketing or advertising of products, goods, or services.

Financial Consent

I authorize Trinity Meds and OpenLoop Health, Inc. to submit on my behalf and release any medical records necessary to process my consultation order. All programs are auto-renewing. There are no refunds or exchanges.

Shipping Authorization

Medication is considered dispensed and the order completed when signed out for shipping, not when delivered. You are responsible for receiving shipments promptly and following storage instructions.