Telehealth Informed Consent

Last updated: [PENDING: launch date]

What telehealth is

Telehealth means receiving healthcare services from a provider using electronic communications, at MelMedic, a scheduled phone or video visit with Melanie Miller, FNP, a licensed family nurse practitioner. During a telehealth visit, your provider can take your history, evaluate your concern, recommend a plan, and, when clinically appropriate, prescribe medication or order labs electronically.

Expected benefits

• Access to a licensed provider from your home, work, or wherever you are.
• Faster, more convenient evaluation for many common health concerns.
• Electronic delivery of prescriptions, lab orders, and care plans.

Possible risks and limitations

• Telehealth is not appropriate for every condition. Some concerns require an in-person examination, imaging, or hands-on testing. If so, your provider will tell you and direct you to appropriate care.
• Information transmitted may be insufficient (for example, poor image quality or an incomplete history) to allow for appropriate decision-making, which may require follow-up or in-person evaluation.
• Technology can fail. If a connection is lost during a visit, we will attempt to reconnect or reschedule at no additional charge.
• In rare circumstances, security protocols could fail, causing a breach of privacy. We use HIPAA-compliant systems (CharmHealth) to minimize this risk.
• Delays in evaluation or treatment could occur due to failures of equipment or technology.

Emergencies

Telehealth visits with MelMedic are not for emergencies. If you experience a medical emergency, call 911 or go to the nearest emergency room. If you are in crisis, call or text 988.

Your rights

• You may withhold or withdraw consent to telehealth at any time without affecting your right to future care or treatment.
• You have the right to know the identity, credentials, and licensure of your provider. Care at MelMedic is provided by Melanie Miller, FNP, licensed with full practice authority in the states she serves [PENDING: state list].
• The laws that protect the confidentiality of your medical information apply to telehealth. See our Notice of Privacy Practices.
• You have the right to ask questions about anything in this consent before your visit.

Scope of services

• Visits are conducted by scheduled appointment, by phone or secure video, for patients physically located in a state where your provider is licensed at the time of the visit. You will confirm your location at booking.
• All clinical decisions, including whether a prescription or lab order is appropriate, are made by the provider during the visit. No specific treatment or outcome is guaranteed.
• MelMedic does not prescribe controlled substances or medical marijuana.
• Prescriptions are transmitted electronically to your pharmacy or, for select therapies, to a licensed U.S. compounding pharmacy that ships to you under your prescription.

Fees

The visit or membership fee ([PENDING-PRICE], see current pricing on the website) is collected at booking through the patient portal. MelMedic is a self-pay practice and does not bill insurance. [PENDING: cancellation/no-show policy.]

Acknowledgment

By scheduling and attending a telehealth visit with MelMedic, you acknowledge that you have read and understood this information, that you have had the opportunity to ask questions, and that you consent to receive care via telehealth. A formal acknowledgment is collected in the patient portal before your first visit.