Telehealth Informed Consent

    Last Updated: February 2, 2026

    Introduction

    This document provides important information about telemedicine services ("telehealth") offered by Cost Plus TRT and its affiliated healthcare providers. Please read this consent form carefully before using our telemedicine services.

    Telehealth involves the use of electronic communications to enable healthcare providers at different locations to share medical information and provide care remotely. This may include consultations via video conferencing, secure messaging, and other digital communication methods.

    Nature of Telehealth Services

    Through Cost Plus TRT's telehealth platform, you may receive the following services:

    • Medical consultations with licensed healthcare providers
    • Review and interpretation of laboratory results
    • Diagnosis and treatment recommendations
    • Prescription of medications when medically appropriate
    • Ongoing monitoring and follow-up care
    • Secure messaging with your healthcare team

    Benefits of Telehealth

    Potential benefits of telehealth include:

    • Convenient access to healthcare without travel
    • Reduced time away from work or family
    • Access to specialized care regardless of location
    • Reduced exposure to contagious illnesses in waiting rooms
    • Faster access to medical consultations
    • Secure and private consultations from your chosen location

    Risks and Limitations

    As with any medical service, there are potential risks and limitations to telehealth:

    • Technical Limitations: Delays or interruptions due to technology failures may occur
    • Physical Examination: The inability to conduct a hands-on physical exam may limit the provider's ability to diagnose certain conditions
    • Security: Despite security measures, electronic communications carry some risk of being intercepted or accessed by unauthorized parties
    • Incomplete Information: There may be limitations in making a diagnosis without complete medical history or physical examination
    • Treatment Limitations: Certain conditions may require in-person evaluation that cannot be provided via telehealth

    In some cases, your provider may determine that telehealth is not appropriate for your condition and recommend an in-person evaluation with a local healthcare provider.

    Emergency Situations

    TELEHEALTH IS NOT APPROPRIATE FOR EMERGENCY SITUATIONS.

    If you are experiencing a medical emergency, including but not limited to chest pain, difficulty breathing, severe allergic reactions, thoughts of self-harm, or any condition requiring immediate attention, please call 911 or go to your nearest emergency room immediately. Do not use our telehealth platform for emergency care.

    Your Rights

    You have the right to:

    • Withhold or withdraw consent to telehealth services at any time
    • Request an in-person consultation instead of telehealth when possible
    • Ask questions about the technology used and your treatment plan
    • Receive information about the healthcare provider treating you
    • Access your medical records as provided by law
    • Privacy and confidentiality of your health information as outlined in our Privacy Policy
    • File a complaint if you believe your rights have been violated

    Your Responsibilities

    By using our telehealth services, you agree to:

    • Provide accurate and complete health information
    • Inform your provider of all medications, supplements, and treatments you are currently using
    • Participate actively in your healthcare decisions
    • Follow your treatment plan and take medications as prescribed
    • Report any changes in your condition or adverse reactions
    • Ensure you are in a private, quiet location during consultations
    • Have appropriate technology and internet connection for the telehealth session
    • Provide a valid phone number for emergencies

    Privacy and Security

    We take your privacy seriously. All telehealth sessions are conducted using secure, HIPAA-compliant technology. Your health information is encrypted during transmission and storage. However, no electronic system is completely secure, and we cannot guarantee absolute security.

    For more information about how we handle your personal and health information, please review our Privacy Policy.

    Licensing and Coverage

    Our healthcare providers are licensed to practice medicine in specific states. Telehealth services are only available to patients located in states where our providers are licensed. You must be physically located in one of our covered states during your telehealth consultation.

    Current covered states include: Colorado, Arizona, Florida, Maine, Montana, Nevada, New Mexico, Ohio, Oregon, Texas, Virginia, Washington, Utah, Nebraska, New York, and Idaho.

    Consent

    By using Cost Plus TRT's telehealth services, you acknowledge that:

    • You have read and understand this Telehealth Informed Consent
    • You understand the benefits, risks, and limitations of telehealth
    • You understand that telehealth is not a replacement for emergency care
    • You voluntarily consent to receive telehealth services
    • You may withdraw your consent at any time

    Contact Us

    If you have questions about telehealth services or this consent form, please contact us:

    Email: support@costplustrt.com
    Phone: 1-888-555-0123