Informed Consent to Telehealth

(a) “Patients” or “Customers” shall mean prospective and returning customers of SCP.

(b) “Practice” refers to an independent medical group that provides Telemedicine Services through the SCP Website.

(c) “Providers” mean licensed and credentialed prescribers who have contracted with or are employed by the Practice and who are made available for Telemedicine Services through the SCP Website.

(d) “Telemedicine Services” means a telehealth encounter and/or the prescribing of prescription drugs when appropriate by a Practice’s Provider to Patients as a result of a telehealth encounter.

(e) “SCP Services” means the provision of Telemedicine Services through the SCP Website.

(f) “SCP Website” means a website and the related platform which facilitates the provision of SCP Services.

Telemedicine Services provided through the SCP Website are conducted by the following independent medical group Practice’s and their Providers:

First Medical Imaging, P.A., Inc.

These independent medical groups and their providers are solely responsible for delivering Telemedicine Services, including virtual consultations, medical evaluations, and prescriptions, using their unfettered professional discretion in compliance with applicable standards of care, federal and state laws and regulations. Each Provider operates independently and is not an employee or agent of SCP. SCP does not practice medicine but acts solely as a facilitator for the provision of Telemedicine Services.

These Telemedicine Services constitute telehealth, a form of health care delivery using electronic communication between a patient and a Provider who are not in the same physical location. Telehealth may include, but is not limited to:

· Electronic transmission of medical records, images, personal health information, and other data.

· Virtual synchronous consultations via audio, video, and/or asynchronous communication (such as secure messaging and email).

· Use of remote monitoring devices, medical equipment, and video/audio files.

SCP employs industry-standard security protocols to protect the privacy, security, and integrity of your health information when using the SCP Services.

While telehealth offers advantages, it has limitations:

· Insufficient Information for Diagnosis – Your Provider may lack sufficient data to make a complete medical decision, requiring an in-person evaluation.

· Limited Physical Examination – Certain assessments, tests, or vital sign monitoring may be unavailable through telehealth.

· Technology Risks – Interruptions due to network failures, software malfunctions, or device errors may disrupt or delay medical care.

· Data Privacy Risks – Despite security measures, electronic data transmission carries a risk of unauthorized access or breaches.

· State-Specific Restrictions – Certain treatments, prescriptions, and medical advice may be restricted or unavailable in some states.

Florida (Fla. Stat. § 456.47)

· Telehealth Providers must be licensed in Florida to provide services.

· Controlled substances cannot be prescribed via telehealth for chronic pain management.

By accepting this Consent to Telehealth, you agree and acknowledge:

1. I have read and understood this Consent to Telehealth, including potential risks and benefits.

2. I voluntarily consent to receive medical care via Telemedicine Services from independent Providers affiliated with SCP.

3. I understand that telehealth is an evolving field, and its applications may extend beyond what is described in this consent.

4. I acknowledge that telehealth does not guarantee specific results, and my condition may remain unchanged or worsen despite treatment.

5. I am responsible for ensuring that the attestation I provide under oath is accurate, complete, and fully covers all information I know to be relevant to my prescription request, my medical history and current condition. I also confirm that any additional information I provide to a Provider, via secure texting, phone, audio, video, or pictorially, about my medical history and current condition will be truthful, accurate, and complete.

6. I understand that certifying to or providing false, misleading, or incomplete health information may result in incorrect treatment, delayed care, or harm.

7. I acknowledge that my Provider may determine that my condition requires in-person care, refuse to prescribe a medication, and/or refer me accordingly.

8. I understand that telehealth does not replace my existing healthcare providers, and I am encouraged and directed to maintain care with them and visit with them immediately after receiving Telemedicine Services.

9. I understand that neither SCP nor the Practices or Providers provide emergency medical care. If I experience a medical emergency, I will call 911 and/or seek immediate in-person assistance.

10. I understand how my health information will be collected, used, and protected in accordance with the SCP Privacy Policy.

11. I have access to my telehealth records in compliance with applicable laws. These records can be accessed through my account on getspecialtycare.com. Additionally, my telehealth records can be requested at privacy@getspecialtycare.com.

12. I understand that my telehealth records will only be shared with SCP and Practices. I may request record transfers by contacting privacy@getspecialtycare.com.

13. I acknowledge that technical failures may cause loss of data or service interruptions. I agree to hold SCP, its subsidiaries, and my Provider harmless for any resulting delays or issues.

14. I may withdraw my consent at any time by emailing privacy@getspecialtycare.com with a written request to discontinue telehealth services.

15. I authorize SCP and my Providers to collect, use, and share my health information for treatment, payment, and healthcare operations, as permitted by law.

16. I acknowledge receipt of the California Open Payments Database notice: The Open Payments Database is a federal tool for researching payments made by drug and medical device companies to physicians and hospitals. It is available at [https://openpaymentsdata.cms.gov](https://openpaymentsdata.cms.gov).

17. I acknowledge there is no guarantee that I will be issued a prescription and that the decision of whether a prescription is appropriate will be made solely in the professional judgment of my Provider.

18. I acknowledge that I will be treated by a Provider licensed in my state. My Provider reserves the right to deny care for potential misuse of the Services or for any other reason if, in the professional judgment of my Provider, the provision of the Services is not medically or ethically appropriate.

19. I acknowledge that there is a risk of technical failures during the telehealth visit beyond the control of SCP and my Provider and will hold the Provider and SCP harmless for such loss.

1. No Warranty of Service – SCP makes no representations or warranties, express or implied, regarding the availability, reliability, accuracy, or uninterrupted operation of the telehealth services. The Services are provided on an “as-is” and “as-available” basis, and SCP expressly disclaims any warranties of merchantability, fitness for a particular purpose, non-infringement, or any warranties arising from course of dealing or usage of trade. SCP shall not be liable for any interruptions, errors, delays, or deficiencies in the Services, including but not limited to technical failures, system outages, security breaches, or unauthorized access to personal health information.

2. No Provider-Patient Relationship with SCP – SCP is not a licensed medical provider or health care facility and does not engage in the practice of medicine or nursing. The independent, licensed health care Providers who deliver telehealth consultations via the Services are not employees, agents, or representatives of SCP. As such, any medical advice, diagnosis, prescriptions, or treatment recommendations provided through the Services are solely the responsibility of the independent Provider, and SCP assumes no liability for any medical decisions, treatment plans, prescriptions, or clinical outcomes arising from a Provider’s care.

3. Prescription Restrictions – The availability of prescription medications through telehealth is subject to applicable state and federal laws, regulations, and medical guidelines. Certain medications, including but not limited to controlled substances and compounded medications are unavailable via SCP. SCP cannot and does not guarantee that any prescription will be issued to a patient following a telehealth consultation, and all prescribing decisions are at the sole discretion of the independent Provider.

4. Informed Consent & Assumption of Risk – By accessing or using the SCP Services, you expressly acknowledge and agree that:

· You have been provided with information regarding the risks, limitations, and benefits of telehealth and have been given an opportunity to ask questions.

· You voluntarily consent to receive health care services via telehealth.

· You understand that telehealth does not replace in-person medical evaluations and that certain conditions may require in-person examination, diagnostic testing, or treatment.

· You assume all risks associated with the use of telehealth, including but not limited to technological failures, security breaches, limitations in physical assessments, delays in care, and the unavailability of certain treatments or prescriptions.

5. Limitation of Liability – To the fullest extent permitted by applicable law, SCP, its affiliates, subsidiaries, officers, directors, employees, contractors, and agents shall not be liable for any direct, indirect, incidental, consequential, special, exemplary, or punitive damages, including but not limited to lost profits, loss of data, or personal injury, arising out of or in connection with (i) your use of or inability to use the Services; (ii) any Provider’s medical advice, treatment, or failure to provide care; (iii) any prescription decision or medication availability; (iv) any telehealth limitations, system failures, or security breaches; or (v) any other matter relating to the Services. In jurisdictions that do not allow the exclusion or limitation of certain liabilities, SCP’s liability shall be limited to the maximum extent permitted by law.

6. Emergency Medical Care Disclaimer – Neither SCP nor the Practices or their Providers provide emergency medical care. If you are experiencing a medical emergency, you must call 911 or seek immediate in-person medical assistance. The Services are not a substitute for emergency or urgent care, and SCP bears no responsibility for any delays or adverse health outcomes resulting from failure to seek emergency medical attention.

By using the SCP Services, you agree that you understand and accept these limitations of liability and disclaimers, and that your continued use of the SCP Services constitutes your legally binding agreement to these terms.

Patient Informed Consent

I acknowledge that I have carefully read, understand, and agree to the terms of this “TELEHEALTH INFORMED CONSENT” and consent to receive the SCP Services.

For questions about this Consent to Telehealth, please contact:

Email: privacy@getspecialtycare.com

Mailing Address:

Specialty Care Pharmacy

5915 Memorial HWY suite 104

Tampa, Fl 33615