Telehealth Informed Consent

1. Purpose of This Consent

This document provides information about the telehealth services offered through Valitide (“the Platform”) and constitutes your informed consent to receive healthcare services via telehealth technology. By submitting your medical intake questionnaire through Valitide, you confirm that you have read, understood, and agree to the terms outlined below.

2. What Is Telehealth?

Telehealth involves the delivery of healthcare services using electronic communications, information technology, or other means between a healthcare provider and a patient who are not in the same physical location. Through Valitide, telehealth services are delivered via an asynchronous (store-and-forward) model in which you submit medical information through a questionnaire that is reviewed by a licensed provider at a later time.

3. Services Provided

Valitide connects you with independently licensed nurse practitioners and other qualified healthcare providers for the evaluation and potential prescription of GLP-1 receptor agonist medications (such as Zepbound, Wegovy, and similar medications) for weight management. Services include:

• Medical intake review based on your submitted questionnaire
• Evaluation of eligibility for GLP-1 therapy
• Asynchronous provider-patient messaging for follow-up questions
• Prescription of GLP-1 medications when medically appropriate

4. Benefits and Risks of Telehealth

Potential benefits include:

• Convenient access to healthcare without travel
• Reduced wait times compared to traditional office visits
• Access to licensed providers regardless of geographic barriers (within licensed states)

Potential risks and limitations include:

• The provider cannot perform a physical examination, which may limit the ability to diagnose certain conditions
• Delays in evaluation or treatment may occur due to technology failures or incomplete information
• In rare cases, information transmitted may be insufficient for appropriate medical decision-making
• Security protocols are in place, but as with any electronic communication, there is a risk of data breach despite best efforts

5. Your Responsibilities

By using Valitide, you agree to:

• Provide accurate, complete, and truthful medical information in your intake questionnaire
• Promptly inform your provider of any changes to your health, medications, or medical conditions
• Follow your provider's instructions regarding prescribed medications, including dosing and administration
• Seek emergency medical care by calling 911 or visiting your nearest emergency room for any urgent or life-threatening conditions — Valitide is not an emergency service
• Maintain the confidentiality of your account credentials

6. Provider Relationship

The healthcare providers on Valitide are independently licensed practitioners. By submitting your intake questionnaire, you are requesting a provider review of your medical information. A provider-patient relationship is established only when a licensed provider reviews your information and takes clinical action (such as approving treatment, requesting additional information, or issuing a prescription). Valitide, as a platform, does not practice medicine and does not make clinical decisions.

7. Prescriptions and Medications

If your provider determines that GLP-1 medication is appropriate for you, a prescription will be issued and sent to a pharmacy. You understand that:

• There is no guarantee that a prescription will be issued — the provider may determine that treatment is not appropriate for you
• GLP-1 medications carry risks and side effects that your provider will evaluate based on your medical history
• You are responsible for following up with your primary care physician or specialist as recommended by your Valitide provider
• Medication costs, insurance coverage, and pharmacy availability are separate from Valitide's platform fee

8. Privacy and Security of Health Information

Valitide is committed to protecting your health information in accordance with the Health Insurance Portability and Accountability Act (HIPAA) and applicable state privacy laws. Your information is:

• Encrypted at rest (AES-256) and in transit (TLS 1.2+)
• Accessible only to your assigned provider, authorized Valitide administrators, and you
• Never sold to third parties or used for advertising
• Subject to our Privacy Policy

9. Right to Withdraw Consent

You may withdraw your consent to telehealth services at any time by contacting us at support@valitide.com. Withdrawing consent will not affect any medical care you have already received. However, withdrawal may limit the ability of providers to continue your treatment through the Platform.

10. Emergency Situations

Valitide is not designed for medical emergencies. If you are experiencing a medical emergency, call 911 or go to your nearest emergency room immediately. Valitide providers may not be available for real-time consultation, and the asynchronous nature of the platform means there may be delays in response.

11. Acknowledgment

By submitting your medical intake questionnaire on Valitide, you acknowledge that:

• You have read and understand this Telehealth Informed Consent
• You voluntarily consent to receive healthcare services via telehealth
• You understand the risks, benefits, and limitations of telehealth
• You understand that results are not guaranteed and a prescription may not be issued
• You have had the opportunity to ask questions about the telehealth process