Consent To Telehealth
Consent to Telehealth
Mode Health provides websites and applications through which you can obtain an online consultation with an independent, licensed health care professional (a “Provider”) and access pharmacy fulfillment services for medications prescribed to you (collectively, the “Services”). The Services constitute a form of telehealth, which involves the delivery of health care services using electronic communications between a health care provider and a patient who are not in the same physical location. We believe telehealth offers convenient, discreet, and accessible care.
Telehealth services may include, but are not limited to:
• Electronic transmission of medical records, photo images, personal health information, or other data between a patient and a Provider;
• Interactions between a patient and a Provider via audio, video, secure messaging, email, and asynchronous communications; and
• Use of data from remote monitoring devices, medical devices, and audio or video files.
The websites, applications, and information systems used by Mode Health incorporate security protocols designed to protect the privacy, security, and integrity of your health information.
Possible Benefits of Telehealth
• Telehealth may make accessing medical care easier, more efficient, and more affordable.
• You may obtain medical care and treatment at times convenient for you.
• You may interact with Providers without requiring an in-office appointment.
Possible Limitations of Telehealth
• Information transmitted to your Provider may not be sufficient for appropriate medical decision-making, and your Provider may determine that treatment via telehealth is not suitable for your condition.
• The inability to conduct certain physical examinations or tests in person may limit diagnosis or treatment options.
• Technical failures may interrupt or delay services.
• Security safeguards may fail, potentially resulting in a breach of personal health information.
• Certain treatments or prescriptions may be unavailable due to applicable laws or regulations.
By accepting this Consent to Telehealth, you acknowledge and agree to the following:
• I have carefully read and understand the risks and benefits of telehealth services.
• I consent to receive medical care and treatment through telehealth from Providers affiliated with Mode Health.
• I understand that telehealth is an evolving field and may involve technologies not specifically described in this consent.
• I understand that no specific results or outcomes can be guaranteed.
• I understand that I must provide accurate and complete health and medical history information.
• I understand that inaccurate or withheld information may result in harm, including serious injury or death.
• I understand that my Provider may determine telehealth is not appropriate for my condition and may recommend in-person care or alternative treatment.
• I understand that the Services supplement and do not replace relationships with existing healthcare providers.
• I understand that emergency services are not provided through the Services, and I should call 9-1-1 or seek immediate medical attention in the event of an emergency.
• I understand that my information, including protected health information, will be collected, used, stored, and shared in accordance with Mode Health’s Privacy Policy and applicable law.
• I understand that I may request access to my telehealth records in accordance with applicable laws and regulations.
• I understand that technical issues may result in delays or interruptions in care.
• I understand that I may withdraw this consent at any time by contacting Mode Health in writing.
• I authorize Mode Health and its affiliated Providers to collect, use, and disclose my information for treatment, payment, healthcare operations, and other purposes permitted by law.
Provider Network:
Ovie Health Group
Clinical Director / Provider:
NP McKenzie, serving as a provider and Clinical Director with Ovie Health Group. NP McKenzie is a board-certified Family Nurse Practitioner and obesity medicine specialist. NPI: 1972131050 Li
All capitalized terms not otherwise defined herein shall have the meanings assigned to them in the applicable Terms of Use. References to “Mode Health,” “we,” “us,” or “our” refer to Mode Health and its affiliated entities, and references to “you” or “your” refer to the individual using the Services.