disclaimer

Any information provided on this webpage is for informational purposes only and should not be construed as medical advice; it is not a substitute for professional medical consultation, diagnosis, or treatment. All patients must consult with a healthcare provider prior to the prescription or dispensing of any medication, which will be done only pursuant to a valid prescription. Compounded drug products are not FDA-approved, and the FDA does not evaluate their safety, effectiveness, or quality. Patients are encouraged to discuss the risks, benefits, and appropriateness of any medications, including compounded products, with their healthcare provider before use.

Telehealth consent page
Telehealth Consent

Palm Beach Aesthetics and Wellness LLC
Beverly Hills Wellness Center & Med Spa
beverlyhillsmedispa.com
This consent explains the use of telehealth for services coordinated by Palm Beach Aesthetics and Wellness LLC (“the Practice”) through the Qualiphy platform.

Qualiphy provides technology that connects patients with healthcare professionals. Clinical services are provided by the medical provider and medical group identified during your encounter. Your provider is responsible for the clinical decisions made during that encounter.

Please read this document and ask any questions before agreeing.

1. What telehealth involves

Telehealth allows a healthcare professional to evaluate you when you are in a different location. Depending on the service and applicable law, your evaluation may involve live video or audio, electronic questionnaires, photographs, medical records, or other health information.

Telehealth may be used to assess whether a requested treatment is appropriate, discuss health concerns, or provide recommendations within the provider’s scope of practice.

2. Benefits, limitations, and alternatives

Telehealth may make care more convenient and reduce travel. However, a remote evaluation may not provide everything available during an in-person examination.

Your provider may request additional records, laboratory testing, an in-person examination, or another specialist’s evaluation. You may choose to seek in-person care instead.

3. Risks of telehealth

Potential risks include interrupted connections, unclear images or sound, incomplete information, misunderstandings, and delays in evaluation. These limitations may affect the provider’s ability to identify a condition or recommend treatment. Electronic systems also carry a risk of unauthorized access or disclosure.

If the connection fails, try to reconnect or contact the Practice for assistance. Seek timely in-person care if your symptoms require attention.

4. Your information and location

Provide accurate and complete information about your health history, allergies, medications, supplements, prior treatments, and any pregnancy or breastfeeding status relevant to your care. Tell your provider about changes in your health.

At each encounter, confirm your identity, current physical location, and a telephone number where you can be reached. Services depend on whether the provider is authorized to care for patients in your location and whether you meet the location requirements presented through Qualiphy. Tell your provider if you are traveling or your location changes.

5. Treatment decisions and prescriptions.

An evaluation does not guarantee clearance for a procedure, a prescription, or a particular result. Recommendations and prescriptions depend on the provider’s assessment and applicable requirements.

This document concerns participation in telehealth. Any recommended medication or procedure requires an appropriate discussion of its specific benefits, risks, and alternatives, together with any additional consent required for that treatment.

6. Ongoing care

When your Qualiphy encounter is a screening or clearance evaluation, it does not establish ongoing management of all your health needs. The Practice remains your primary contact for questions about services it coordinates and treatment it provides. Follow the encounter instructions for questions directed to the evaluating provider.

Continue care with your primary care clinician and other treating professionals. Tell them about relevant treatments and medications.

7. Privacy and medical records

Information from your encounter may become part of your medical record and may be shared with the Practice and other participants in your care as permitted by applicable law. Applicable privacy notices explain how information is handled.

Use a private setting and protect access to your device and account. Tell your provider if anyone else is present. Ask about any recording before the encounter begins.

You may request access to your records or ask that records be sent to another healthcare professional, subject to applicable authorization and legal requirements.

8. Emergencies

Telehealth through this service is not an emergency service. Call 911 or go to the nearest emergency department for a medical emergency. Do not wait for a portal message, callback, or telehealth appointment.

9. Voluntary participation and fees

You may decline telehealth or withdraw your consent by telling your provider or contacting the Practice. Withdrawal applies to future services and does not reverse care already provided. An alternative care arrangement may be necessary.

Fees, insurance participation, cancellation terms, and refund policies are addressed separately. Review those terms before purchasing services. This consent does not itself authorize recurring charges.