Telemedicine Informed Consent

• I grant my consent and allow the healthcare professionals associated with My Doctor Online, such as physicians, Physician Assistants, Nurse Practitioners, and Medical Assistants, to conduct medical evaluations and treatments as they deem necessary. I absolve My Doctor Online.com Inc from any legal liabilities that might arise from their medical services.
• I understand that digital communication systems will facilitate my interaction with my healthcare professionals remotely, distinguishing it from face-to-face visits since I won’t be in the same physical space as my doctor.
• I understand that this technology carries possible risks such as disruptions, breaches of security, and technological issues.
• I understand that my health data could be disclosed to My Doctor Online‘s medical personnel and pharmaceutical staff to facilitate suitable drug therapy and treatment plans. All the medical experts associated with My Doctor Online are committed to upholding the privacy of this information.
• Telemedicine, also referred to as Telehealth, presents the possibility of incorrect or delayed diagnoses, which could result in patients either not getting the right treatment or receiving an improper one. Despite being aware of these potential pitfalls, I am ready to continue with a virtual consultation through My Doctor Online.
• I acknowledge the risks associated with incorrect or late diagnoses and am prepared to seek urgent medical attention if my condition does not show signs of improvement within a reasonable time frame, usually within 48 hours.
• I understand that the therapy, treatment, or suggestions given by My Doctor Online‘s healthcare professionals serve as an introductory and primary solution, and I am willing to schedule further consultations with a physician in person when necessary.
• I understand that either the healthcare provider or I have the option to cease the telemedicine consultation should we determine that the electronic communication tools are insufficient for our needs.
• I understand that I am entitled to revoke my consent for the use of telemedicine or telehealth services at any moment during my treatment process. While my consent remains valid, the My Doctor Online medical team can offer healthcare services via telemedicine without requiring me to fill out another consent form.
• I have been informed about the options for telemedicine and telehealth consultations, and I have decided to engage in one. I acknowledge that certain aspects of the examination requiring physical assessments might be constrained since I won’t be physically present with my medical practitioner.

I understand that My Doctor Online employs both real-time synchronous and asynchronous (store and forward) communication methods to provide healthcare services. I have explored the website www.mydoctoronline.com to learn more about these telemedicine approaches and their operational boundaries.

• I certify that I am either an adult patient myself or the legal guardian of a minor patient in order to access the My Doctor Online platform.
• I understand that the services offered through My Doctor Online cannot be refunded.
• I understand that the fee I pay to My Doctor Online for the consultation might not include the cost of the medication prescribed to me, meaning I will also have to pay for the prescribed medication when I pick it up from the pharmacy.
• I understand that the details I provide on the medical history form should be fully filled out, precisely reflect my current state, and kept updated as accurately as I can.
• I understand that by not providing accurate, complete, and truthful details on the intake form, I expose myself to the risk of incorrect diagnoses and insufficient treatment.
• I understand that My Doctor Online reserves the right to reject treatment if the patient or user provides deceptive information.