Telehealth Consent

Alternate Health Club (AHC) Consent to Telehealth

Introduction

Alternative Health Club (AHC) provides medical weight loss and other health services via telehealth. By proceeding with registration and using our services, you acknowledge that you have read, understood, and agreed to the terms outlined in this consent.

Understanding Telehealth & Asynchronous Telemedicine

Telehealth involves the use of electronic communication to provide healthcare services remotely when the patient and provider are in different locations.

AHC primarily utilizes asynchronous telemedicine, also known as “store-and-forward” communication. This means that instead of a live, real-time consultation, you will submit your medical information, such as a health questionnaire, photos, or other necessary details. A licensed healthcare provider will then review your information at a later time and make an assessment regarding your treatment plan.

In some cases, due to state law requirements, we may need to conduct a synchronous telemedicine visit (a real-time video or phone consultation). If this applies to your state, we will inform you and arrange a live consultation as needed.

Potential Risks of Using Telehealth

While telehealth offers convenience, there are inherent risks, including but not limited to:

• Technical Issues: Delays, interruptions, or disruptions due to equipment or network failures.
• Security Risks: While we employ strong security measures, electronic communication always carries a risk of unauthorized access.
• Limitations of Remote Care: Some medical conditions may not be suitable for telehealth evaluation and may require an in-person visit.

Patient Acknowledgments

By proceeding with registration and using AHC’s telehealth services, you acknowledge and agree to the following:

1. Voluntary Participation: You voluntarily consent to telehealth services provided by AHC.
2. Identification Verification: You may be required to submit a valid photo ID for identity verification.
3. Nature of Services: Most visits will be asynchronous, but a synchronous consultation may be required based on state law.
4. Confidentiality: AHC follows HIPAA guidelines to protect your personal and medical information. However, electronic communications involve some inherent security risks.
5. Not for Emergencies: Telehealth services are not for emergency situations. If you experience a medical emergency, call 911 or go to the nearest emergency room.
6. Technology Requirements: You are responsible for ensuring you have access to the necessary technology (e.g., internet and a compatible device) to use telehealth services.
7. Financial Responsibility: You are responsible for any fees associated with your telehealth visit and for any charges from your internet or phone service providers.
8. Consent to Treatment: By proceeding, you consent to receiving healthcare services through AHC via telehealth.

Contact Information

If you have any questions regarding telehealth services, please contact us:
Phone: 631-647-0162
Email: support@alternativehealthclub.com

Mail to:
1309 Coffeen Avenue STE 1200
Sheridan Wyoming 82801

Binding Agreement

By completing the registration process and engaging in AHC’s telehealth services, you confirm that you have read, understood, and accepted this consent form. Your continued use of our services signifies your legal agreement to these terms.