Effective Date: 5/11/26

This Telehealth Consent Agreement (“Agreement”) explains the use of telehealth services provided through Regenesis Health & Wellness (“Regenesis,” “we,” “our,” or “us”). By participating in telehealth services, you acknowledge that you have read, understood, and agreed to the terms outlined below.

1. What Is Telehealth?

Telehealth involves the use of electronic communications and technology to allow healthcare providers and patients to communicate remotely for purposes including:

  • Consultations
  • Evaluations
  • Follow-up care
  • Health education
  • Treatment planning
  • Prescription management when appropriate

Telehealth services may include video conferencing, phone calls, electronic messaging, secure forms, and other digital communication platforms.

2. Nature of Telehealth Services

I understand that telehealth differs from in-person medical care and may have limitations, including:

  • Inability to perform certain physical examinations
  • Potential technical difficulties or interruptions
  • Delays in evaluation or communication
  • Limited ability to respond to emergencies remotely

I understand that telehealth may not be appropriate for every medical concern or condition.

3. Risks of Telehealth

I acknowledge that potential risks associated with telehealth services may include:

  • Technical failures or connectivity issues
  • Unauthorized access despite reasonable security measures
  • Incomplete transmission of medical information
  • Limitations in diagnosis or treatment due to lack of in-person evaluation

While Regenesis takes reasonable steps to protect privacy and security, no electronic communication system can be guaranteed to be completely secure.

4. Benefits of Telehealth

I understand that potential benefits of telehealth may include:

  • Improved access to care
  • Increased convenience and flexibility
  • Reduced travel time
  • Enhanced continuity of care
  • More efficient communication and follow-up

5. Provider Discretion & Treatment Eligibility

I understand that:

  • Participation in telehealth does not guarantee treatment eligibility or prescription approval
  • All treatment recommendations are subject to provider evaluation and discretion
  • Additional laboratory testing, medical records, or in-person evaluation may be required before treatment is approved

6. No Emergency Care

I understand that telehealth services provided through Regenesis are not intended for emergency medical situations.

If I experience a medical emergency, I agree to:

  • Call 911 immediately
  • Contact emergency medical services
  • Seek immediate in-person medical attention

I understand that Regenesis providers may not be immediately available for urgent or emergency concerns.

7. Patient Responsibilities

By participating in telehealth services, I agree to:

  • Provide accurate and complete health information
  • Disclose medications, medical history, and symptoms honestly
  • Follow provider instructions and recommendations
  • Use telehealth services in a safe and private environment when possible
  • Protect access to my own devices and accounts

8. Privacy & Confidentiality

I understand that medical information shared during telehealth visits may constitute protected health information (“PHI”) and will be handled in accordance with applicable privacy practices and policies.

I acknowledge that electronic communications may carry some privacy and security risks despite reasonable safeguards.

9. Consent to Telehealth Services

By using telehealth services through Regenesis Health & Wellness, I voluntarily consent to participate in telehealth consultations, evaluations, communications, and related services.

I understand that I may withdraw consent to telehealth services at any time by notifying Regenesis Health & Wellness, although doing so may impact my ability to receive certain services.

10. Contact Information

If you have questions regarding this Telehealth Consent Agreement, please contact:

Regenesis Health & Wellness
support@regenesishealthandwellness.com