Telehealth Consent

Informed Consent Regarding Use Of Telehealth

Last updated: November 12, 2024

BY CLICKING “I AGREE,” CHECKING A RELATED BOX TO SIGNIFY YOUR ACCEPTANCE, USING ANY OTHER ACCEPTANCE PROTOCOL PRESENTED THROUGH THE SERVICE, OR OTHERWISE AFFIRMATIVELY ACCEPTING THIS CONSENT, YOU ACKNOWLEDGE THAT YOU HAVE READ, ACCEPTED, AND AGREED TO BE BOUND BY THIS CONSENT. IF YOU DO NOT AGREE, DO NOT CREATE AN ACCOUNT OR USE THE SERVICE. BY AGREEING, YOU ALSO AUTHORIZE ANY PARTY WHO CLICKS “I AGREE” OR OTHERWISE ACCEPTS THIS CONSENT ON YOUR BEHALF.

Purpose

This consent form (“Consent”) provides information about telehealth and obtains your informed consent for the use of telehealth by Ulo’s third-party healthcare providers and professionals. By accepting, you consent to healthcare services delivered through Ulo’s platform by these providers, including but not limited to physicians, nurse practitioners, physician assistants, and mental health professionals.

Telehealth Services

Telehealth services may include diagnosis, treatment, follow-up, and patient education and may involve:

  1. Health records and test results.
  2. Images and asynchronous communications.
  3. Live two-way audio and video.
  4. Interactive audio with store and forward technology.
  5. Output data from medical devices and audio/video files.

You have alternatives to telehealth, including in-person services, and may choose to switch at any time. Always discuss alternative options with your provider.

Benefits And Limitations

Telehealth improves accessibility and timeliness of care, providing potential benefits such as easier access to services, reduced travel time, and prompt responses. However, telehealth may involve risks, including:

  1. Limited diagnostic accuracy due to lack of physical examination.
  2. Potential technological failures affecting the quality of care.
  3. Risks of data breaches or unintended disclosures.
  4. Limited provider capabilities to address all conditions remotely.

These services do not replace the need for primary care or emergency services. Telehealth sessions are not recorded by providers or Ulo.

Data Privacy And Security

The electronic systems used by Ulo incorporate security protocols to protect data privacy and prevent intentional or unintentional corruption. Personal information and protected health information (PHI) will only be disclosed as legally authorized for treatment, billing, or administrative purposes, or when mandated (e.g., harm to self/others, abuse reporting). However, Ulo cannot guarantee the security of third-party platforms (e.g., email providers).

Payment, Prescription, And Lab Services

You are responsible for all costs associated with telehealth, including any prescriptions and diagnostic tests, which may be performed by third-party labs. Ulo and its partners do not guarantee the accuracy or reliability of such tests.

You may not submit a claim to Medicare, any other federal payor, or state/private insurers for telehealth services obtained through Ulo.

Consent To Telehealth Services

By engaging with Ulo, you agree to the terms outlined above and consent to the provision of health services under these conditions.