Telehealth Informed Consent and Disclosure

Telegenix LLC
Effective Date: January 21, 2026

This Telehealth Informed Consent and Disclosure (“Consent”) governs your use of telehealth services made available through Telegenix LLC and participating independently owned medical practices and licensed healthcare professionals (collectively, “Provider” or “Providers”).

By clicking “I Agree,” signing electronically, or otherwise proceeding with telehealth services, you acknowledge that you have read, understood, and agreed to this Consent.

1. Purpose and Scope

This Consent describes:

• how telehealth services may be delivered;
• the benefits, limitations, and risks of telehealth;
• your rights and responsibilities as a patient; and
• how legal and clinical requirements may vary based on your location.

This Consent applies to telehealth encounters facilitated through Telegenix, including evaluations, treatment planning, follow-up care, and care coordination, as applicable.

2. What Telehealth Includes

For purposes of this Consent, “telehealth” means healthcare services delivered when you and your Provider are not in the same physical location, including by one or more of the following:

• secure video conferencing,
• audio-only interactions (where permitted),
• secure messaging or portal communications,
• remote review of medical history, lab results, and other clinical data, and
• electronic prescribing and care coordination, where legally and clinically appropriate.

3. Services Potentially Available via Telehealth

Depending on clinical appropriateness and legal availability, telehealth services may include, without limitation:

• metabolic health and weight-management consultations,
• medical weight-loss treatment options, including GLP’s
• hormone-related evaluations and management,
• wellness and performance-oriented care,
• peptide-related consultations,
• review and ordering of laboratory testing,
• mobile IV therapy assessments and oversight, and
• ongoing monitoring and follow-up visits.

Telehealth is not appropriate for every condition. Your Provider determines whether telehealth is suitable for your care.

4. Multi-State Care and Jurisdictional Limits

Telegenix supports care for eligible patients in multiple U.S. jurisdictions. You understand and agree that:

• services are only provided where the treating Provider is appropriately licensed, credentialed, or otherwise authorized;
• your physical location at the time of each encounter may affect whether care can be delivered and what treatment options are available;
• certain states may impose additional requirements (for example, video visit requirements, supplemental consent, laboratory testing, or in-person evaluation); and
• telehealth services may be delayed, limited, or unavailable if legal requirements are not met.

5. Potential Benefits of Telehealth

Potential advantages may include:

• improved convenience and access to qualified clinicians,
• reduced travel and scheduling burden,
• more efficient follow-up and care continuity, and
• timely review of labs and treatment response.

No specific clinical outcome is guaranteed.

6. Material Risks and Limitations

You acknowledge the following limitations and risks of telehealth, including but not limited to:

• interruptions due to technology failure (internet, software, hardware),
• reduced ability to perform complete physical examination remotely,
• potential delays in diagnosis or treatment if data is incomplete or inaccurate,
• potential privacy/security risks inherent to electronic communication, and
• need for in-person care, urgent care, or emergency services when clinically indicated.

Your Provider may determine that telehealth is insufficient and require in-person evaluation before initiating or continuing care.

7. Emergency and Urgent Conditions

Telehealth services provided through Telegenix are not emergency services.

If you believe you are experiencing a medical emergency, call 911 immediately or go to the nearest emergency department.

Examples include, without limitation: chest pain, severe shortness of breath, stroke-like symptoms, severe allergic reactions, uncontrolled bleeding, or thoughts of self-harm.

8. Labs, Prescriptions, and Third-Party Clinical Services

As part of your care, your Provider may recommend or order laboratory testing, medications, or other services when clinically appropriate and legally permissible.

You understand and agree that:

• prescribing decisions are made solely in the Provider’s independent medical judgment;
• prescribing is never guaranteed;
• some therapies may require baseline or interval labs, additional follow-up, or in-person assessment;
• laboratory, pharmacy, and mobile IV services may be performed by independent third parties; and
• prescribing and refill practices are subject to federal and state law, clinical standards, and safety considerations.

9. Privacy, Security, and Electronic Communications

Telegenix and participating Providers use reasonable safeguards to protect your information. However, no electronic system is completely secure.

By using telehealth services, you acknowledge:

• electronic communications may involve some privacy/security risk,
• email, text, and phone communications may not always be encrypted, and
• you are responsible for maintaining the security of your own devices, networks, and account credentials.

Your information handling is also governed by applicable privacy notices, including Telegenix’s Privacy Policy and Notice of Privacy Practices, as applicable.

10. Patient Responsibilities

You agree to:

• provide complete and accurate health information, including medications, allergies, and medical history;
• promptly report adverse effects, new symptoms, or changes in condition;
• participate from a private, safe, and appropriate environment;
• provide your current physical location when requested at the start of a visit;
• follow care instructions, including labs, follow-up appointments, and medication guidance; and
• avoid using telehealth services for emergency situations.

Failure to provide accurate information may limit or prevent safe treatment.

11. Financial Responsibility

Unless otherwise stated in writing, you are financially responsible for charges associated with telehealth visits and related services, including laboratory testing, medications, and third-party clinical services.

You further acknowledge:

• out-of-network status may apply,
• insurance reimbursement is not guaranteed, and
• you are responsible for amounts not covered by insurance or third-party payors.

Applicable pricing and payment terms are provided through Telegenix policies, checkout materials, or plan documentation.

12. Right to Revoke Consent

You may revoke this Consent at any time by providing written notice to Telegenix. Revocation:

• does not apply retroactively to services already rendered, and
• may limit or terminate your ability to receive ongoing telehealth services through Telegenix.

13. Acknowledgment and Authorization

By selecting “I Agree” or signing electronically, you represent and agree that:

• you have read this Consent in full;
• you understand the nature of telehealth, including its benefits and risks;
• you have had the opportunity to ask questions and seek clarification;
• you voluntarily consent to receive telehealth services through Telegenix and participating Providers; and
• you authorize the use of telehealth technologies for assessment, diagnosis, treatment planning, follow-up, and related care coordination, as permitted by applicable law.

YOU EXPRESSLY CONSENT TO RECEIVE TELEHEALTH SERVICES THROUGH TELEGENIX LLC.