Consent to Telehealth

By checking the box next to these terms of use and/or any other similar form that may be provided to
you from VirtuMed Solutions, LLC dba Virtumedsolutions.com, you agree to its use.

A LEGAL SIGNATURE AND ONGOING AGREEMENT TO THESE TERMS OF USE (IN WHATEVER FORM) IS
CONSTITUTED BY YOUR CONTINUED USE OF THE SITE AND YOUR REGULAR ACCEPTANCE OF THESE
TERMS OF USE.
ACONSENT TO TELEHEALTH YOU AGREE THAT BY CHECKING THE BOX FOR THESE TERMS OF USE
AND/OR ANY OTHER SUCH FORM OF THE SAME PRESENTED TO YOU FROM TIME TO TIME ON THE SITE,
YOU ARE AGREEING TO THESE TERMS OF USE AND THAT SUCH CONTINUOUS ACTIONS IN USING THE
SITE CONSTITUTE A LEGAL SIGNATURE AND ON-GOING AGREEMENT TO CONSENT.

The delivery of healthcare services via electronic communications, information technology, or other
channels between a healthcare provider is known as telemedicine and/or telehealth. Telemedicine
includes, but is not limited to: Electronic transmission of medical records, photo images, personal health
information or other data between a member and a healthcare provider; Interactions between a
member and healthcare provider via audio, video and/or data communications; and use of output data
from medical devices, sound and video files. Telemedicine may be used for diagnosis, treatment, follow-
up, and/or member education.

The Virtumedsolutions electronic systems will incorporate network and software security protocols to
safeguard the security and privacy of health information and imaging data. These protocols will also
include safeguards to ensure the data’s integrity against malicious or unintentional corruption.
Potential Telemedicine and/or Telehealth Hazards may include:

A. The information sent to your provider(s) may not be sufficient for the provider to make an
appropriate medical decision(s).

B. Your provider may not be able to provide medical treatment for your specific condition via
telemedicine, and you may be required to seek alternative care. In some cases, the inability of
your provider(s) to conduct certain tests or assess vital signs in-person may prevent the
provider(s) from providing a diagnosis or treatment or from identifying the need for emergency
medical care or treatment for you.

C. Security measures or protections could malfunction, resulting in a violation of privacy, delaying
medical evaluations or treatments. Considering regulatory constraints in some jurisdictions,
your provider(s) treatment alternatives, particularly with regard to specific prescriptions.

By agreeing to this Consent to Telehealth, you confirm that you comprehend and accept the following:

I understand the risks and advantages of using telemedicine in the medical care and treatment given to
me by “Providers” through Virtumedsolutions platform, and I have carefully read this Special Consent to
Telehealth.

I understand that the delivery of healthcare services via telemedicine is an evolving field and that the
use of telemedicine in my medical care and treatment may include uses of technology not specifically
described in this consent, and I hereby give my informed consent to the use of telemedicine by
providers affiliated with VirtuMed Solutions, LLC dba Virtumedsolutions.com.

I am aware that while using telemedicine may have some advantages for me, there are no guarantees
with any type of medical care.  And I hold harmless Vitrtumedsolutions.com, the medical practitioners,
and/or staff of VirtuMed Solutions, LLC dba Virtumedsolutions.com.

By consenting to this; I am waiving any future ability to pursue any action against
VirtuMed Solutions, LLC dba Virtumedsolutions.com.  Any medical professional registered nurse, nurse practitioner or medical doctor who provides
service through the Virtumedsolutions.com patient portal, telehealth services, or any collaboration
involving these medical professionals, Virtumedsoltions.com and their sales and/or operating staff.

Additionally, I agree that continuing with the purchase of products and/or services provided by
VirtuMed Solutions, LLC dba Virtumedsolutions.com warrants my consent to these terms and all
other terms disclosed by VirtuMed Solutions, LLC dba Virtumedsolutions.com.

I am aware that I may refuse or revoke this consent at any time by emailing Virtumedsoutions.com to do
so. If not, this authorization will be regarded as renewed by every new telemedicine consultation with
“Providers,” engage.