Telehealth involves the use of electronic communications to enable healthcare providers at different locations to share individual patient medical information for the purpose of improving patient care.

Services Provided

Telehealth services offered by Mederva MedicalCorporation ,(“Mederva Health”), and Mederva Health’s engaged providers (our“providers”) will include a patient consultation, diagnosis, and recommendation(the “Service”). The Services provided may also include chart review, health information sharing, and non-clinical services, such as patient education. The information you provide may be used for diagnosis, therapy, follow-up and/or patient education, and may include any combination of the following: (1) a review of health records, images, and/or test results via asynchronous communications; (2) interactive audio with store and forward; or (3) output data from medical devices and sound and video files.

The electronic communication systems we use will incorporate network and software security protocols to protect the confidentiality of patient identification and imaging data and will include measures to safeguard the data and to ensure its integrity against intentional or unintentional corruption.

Expected Benefits

• Improved access to care by enabling you to remain in your home while the Mederva Health’s provider consults and obtains test results at distant/other sites.
• More efficient care evaluation and management.
• Obtaining expertise of a specialist as appropriate.

Possible Risks

• Delays in evaluation and treatment could occur due to deficiencies or failures of the equipment and technologies.
• If we experience connection difficulties or can’t communicate with you clearly, then we may need to reschedule the services.
• In very rare events, security protocols could fail, causing a breach of privacy of personal medical information.
• In rare events, a lack of access to complete medical records may result in adverse drug interactions or allergic reactions or other judgment errors.

Service Limitations:

Our providers do not address urgent cases or medical emergencies. If you believe you are experiencing a medical emergency, you should go to the nearest urgent care center or emergency room. After receiving urgent healthcare treatment, you should visit your primary care doctor.

Our providers are an addition to, and not a replacement for, your primary care physician. Responsibility for your overall medical care should remain with your local primary care doctor, if you have one, and we strongly encourage you to locate one if you do not.

By using services on this Site, you acknowledge that you understand and agree with the following terms of this “Telehealth Informed Consent”:

1. I hereby consent to receiving Mederva Health’s services via telehealth technologies. I understand that Mederva Health and its providers offer telehealth-based medical services, but that     these services do not replace the relationship between me and my primary     care doctor. I also understand it is up to the Mederva Health provider to     determine whether or not my specific clinical needs are appropriate for a telehealth encounter.
2. I understand that federal and requires health care providers to protect the privacy and the security of health information. I understand that Mederva Health will take steps to make sure that my health information is not seen by anyone who should not see it. I understand that telehealth may involve electronic communication of my personal medical information to other health practitioners who may be located in other areas, including out of state.
3. I understand there is a risk of technical failures during the telehealth encounter beyond the control of Mederva Health. I agree to hold harmless Mederva Health for delays in evaluation or for information lost due to such technical failures.
4. I understand that I have the right to withhold or withdraw my consent to the use of telehealth in the course of my care at any time, without affecting my right to future care     or treatment. I understand that I may suspend or terminate use of the telehealth services at any time for any reason or for no reason. I understand that if I am experiencing a medical emergency, that I will be directed to dial Emergence Medical Services immediately and that the Mederva Health providers are not able to connect me directly to any local emergency services.
5. I understand that I may expect the anticipated benefits from the use of telehealth in my care, but that no results can be guaranteed or assured.
6. I understand that my healthcare information may be shared with other individuals for scheduling, translating and billing purposes. Persons may be present during the consultation other than the Mederva Health provider in order to operate the telehealth     technologies. I further understand that I will be informed of their presence in the consultation and thus will have the right to request the following: (1) omit specific details of my medical history/examination that are personally sensitive to me; (2) ask non-medical personnel to leave the telehealth examination; and/or (3) terminate the consultation at any time.
7. I understand that there is no guarantee that I will be issued any prescription and that the decision of whether a prescription is appropriate will be made in the professional judgment of my provider. If my provider issues a prescription, I have the right to select the pharmacy of my choice.
8. I understand that if I participate in a consultation, that I have the right to request a copy of my medical records which will be provided to me at reasonable cost of preparation, shipping and delivery.

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