Telehealth Informed Consent

Telehealth is the delivery of healthcare using electronic communications rather than an in-person visit. Your care may be delivered asynchronously (you submit an intake and a provider reviews it later) or synchronously (a live video or phone visit). Your provider is independently licensed in the state where you are located.

• Access to a licensed provider without travel or a waiting room.
• Faster evaluation and, when appropriate, faster access to treatment.
• More privacy for a condition many people are uncomfortable discussing in person.

• A provider cannot perform a physical examination, and some conditions cannot be diagnosed without one.
• Erectile dysfunction can be an early sign of cardiovascular disease, diabetes, hormonal disorders, or depression. Telehealth is not a substitute for regular in-person primary care, and you should follow up with a primary care provider.
• If the information you provide is incomplete or inaccurate, the provider may reach an incorrect conclusion.
• Technology failures, delays, or, in rare cases, a security breach could affect your care or your data.
• The provider may determine that telehealth is not appropriate for you and may refer you for an in-person evaluation instead.

There is no guarantee that you will be prescribed medication. The provider exercises independent clinical judgment and may decline to prescribe, request more information, order labs, or refer you elsewhere.

If you are prescribed a compounded tadalafil/sildenafil rapid-dissolve tablet, you acknowledge that this combination product is prepared by a licensed compounding pharmacy and is not FDA-approved as a combination, and that the FDA does not review compounded drugs for safety, effectiveness, or manufacturing quality.

• You may withdraw this consent and stop telehealth services at any time without affecting your right to future care.
• You may request an in-person referral at any time.
• You may request a copy of your medical record.
• Your information is protected under applicable state and federal privacy laws, including HIPAA.

Telehealth is not for emergencies. If you experience chest pain, sudden vision or hearing loss, or an erection lasting more than 4 hours, call 911 or go to the nearest emergency department.

Contact support@getdickbig.com with any questions about this consent.