TeleHealth Consent

TELEHEALTH CONSENT FORM

Last Updated: March 1, 2026 I understand that Telehealth involves delivering health care services through communication technologies (such as the internet or cellphone) to support diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care.

By acknowledging my consent below, I understand and agree to the following:

I understand that Longevity Meds offers Telehealth consultations conducted via videoconferencing, telephonic, and asynchronous methods, and my Telehealth provider will not be physically present with me during the session.
I understand there are potential risks associated with Telehealth technology, including but not limited to interruptions, delays, unauthorized access, or other technical issues. I understand that either my Telehealth provider or I can discontinue the Telehealth appointment if the technical connections are not sufficient for the visit.
I understand that I have the option to seek an in-person office visit instead of Telehealth care, and I am voluntarily choosing to participate in a Telehealth consultation with a Longevity Meds provider.
I acknowledge that a consultation with a clinician is required, and I understand that my treatment request may be declined based on their professional assessment.
To maintain the confidentiality of my health information, I agree to conduct my Telehealth consultation in a private location, and I understand that my Telehealth provider will also be in a private location.
In an emergency situation, I understand that my Telehealth provider's responsibility may be to direct me to emergency medical services, such as visiting an emergency room.

By acknowledging below, I certify:

that I have read this form and/or had it explained to me;
that I understand the risks and benefits of a Telehealth appointment;
that I have been given the opportunity to ask questions and that such questions have been answered to my satisfaction.

CONSENT TO TEXT OR EMAIL USAGE FOR APPOINTMENT REMINDERS AND OTHER HEALTHCARE REMINDERS By signing below, I consent to receive text messages from the practice at my phone number or emails to receive appointment reminders and general health reminders or information. I understand that this consent for emails and/or text messages will apply to all future appointment reminders, feedback, and health information unless I request a change in writing. I also acknowledge that these means of communication are not considered secure for transmitting private information.

Longevity Meds is a technology platform that collaborates with independent healthcare professionals to deliver high-quality services through our patient management system. We do not directly provide medical or pharmacy services, and payment does not guarantee that a prescription will be written or medication dispensed. All medical services are handled by independent providers. The information on this site is for informational purposes only and is not a substitute for professional medical advice. For any health concerns, please consult your licensed healthcare provider. Our platform advertises services, not specific medications.

Disclaimer: FDA-approved brand-name drugs such as Wegovy® and Ozempic® are available exclusively from Novo Nordisk®. Mounjaro® and Zepbound® are available exclusively from Eli Lilly and Company®. Longevity Meds claims no affiliation with or endorsement from the above products or entities.

Longevity Meds 378 Grand Ave Pawtucket, RI 02861