Telehealth Informed Consent

By submitting an intake, you acknowledge that you have read and agree to this Telehealth Informed Consent. This document explains the nature of telehealth services provided through Milos MD and the LocumTele provider network.

Nature of telehealth

Telehealth involves the use of electronic communications to enable a licensed healthcare provider located in one place to evaluate a patient located in another. Milos MD primarily offers asynchronous telehealth: you submit information through an online intake, and a provider reviews it without a live video or phone visit unless one is specifically requested.

Provider–patient relationship

Clinical services are provided by independent clinicians in the LocumTele network. A provider–patient relationship is established when a clinician reviews your intake and issues clinical guidance or a prescription.

Expected benefits

• Convenient access to a licensed clinician without an in-person visit.
• Efficient evaluation and, when appropriate, prescription fulfillment.

Potential risks and limitations

• Information you provide may be insufficient for a safe clinical decision, in which case the provider may request more information or decline to prescribe.
• Delays in electronic communication can occur.
• Asynchronous evaluation does not replace emergency care or in-person examination when either is needed.
• Technical failures could disrupt the service; protected health information could, despite reasonable safeguards, be intercepted.

Emergencies

Telehealth is not appropriate for medical emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency department.

Confidentiality and records

Records of your telehealth encounter are maintained in accordance with applicable law and our HIPAA Notice of Privacy Practices.

Your rights

• You may withdraw this consent at any time by contacting suport@milosmd.com. Withdrawal does not affect care already provided.
• You may request that a different provider review your case.
• You may seek in-person care at any time.

Acknowledgment

By continuing with an intake through Milos MD, you acknowledge that you have read this consent, that your questions have been answered to your satisfaction, and that you voluntarily consent to receive telehealth services from a LocumTele provider.