Consent to Telehealth Services

1. Purpose of This Consent

This Consent to Telehealth Services (“Consent”) explains your agreement to receive healthcare services through telehealth technologies facilitated by Revano Life, LLC (“Revano,” “we,” “us,” or “our”) and independent licensed healthcare providers.

By checking the consent box, creating an account, or using the Services to access care, you acknowledge and agree to this Consent.

2. Nature of Telehealth

Telehealth involves the use of electronic communications and technology to provide healthcare services without an in-person visit. This may include:

• Video consultations
• Audio-only communication (where permitted)
• Secure messaging
• Digital intake forms and questionnaires
• Review of uploaded medical information

Telehealth services are provided by independent licensed healthcare professionals, not by Revano.

3. Consent to Receive Care via Telehealth

You voluntarily consent to receive healthcare services via telehealth, including evaluation, diagnosis, treatment recommendations, and prescription of medications when clinically appropriate by an independent licensed provider.

You understand that you may withdraw your consent at any time by discontinuing use of the Services, subject to provider policies and applicable law.

4. Limitations of Telehealth

You understand and acknowledge that:

• Telehealth is not appropriate for all medical conditions
• Providers may determine that an in-person visit is necessary
• A physical examination is not performed during telehealth visits
• Diagnosis and treatment decisions are based on information you provide and available remote assessment tools

5. Risks of Telehealth

You acknowledge potential risks, including but not limited to:

• Delays in medical evaluation due to technology or connectivity issues
• Miscommunication due to lack of in-person examination
• Technical failures in communication systems
• Unauthorized access despite security safeguards

You agree that these risks are reasonable in relation to the benefits of telehealth.

6. Privacy and Security

You understand that telehealth communications may involve electronic transmission of personal health information. While reasonable safeguards are used to protect your data, no system is fully secure.

You acknowledge and accept the risks associated with electronic communication.

7. Alternatives to Telehealth

You understand that alternatives to telehealth may include:

• In-person visits with a healthcare provider
• Emergency medical services
• Specialty or urgent care clinics

You may choose to seek in-person care at any time.

8. Provider Independence

Healthcare services are provided by independent licensed professionals who are solely responsible for:

• Medical evaluation and diagnosis
• Treatment recommendations
• Prescribing medications
• Determining the appropriate standard of care

Revano does not provide medical care or interfere with clinical decision-making.

9. No Guarantee of Treatment or Prescription

You understand and agree that:

• A provider may determine that treatment is not appropriate
• A prescription may not be issued
• Services are subject to clinical judgment and applicable laws

10. Emergency Situations

Telehealth services are not appropriate for emergencies.

If you are experiencing a medical emergency, call 911 or seek immediate in-person care.

11. Acknowledgment and Agreement

By checking the consent box or proceeding with use of telehealth services through Revano, you acknowledge that:

• You have read and understand this Consent
• You voluntarily agree to receive telehealth services
• You understand the risks, benefits, and limitations described above
• You understand that Revano is not a healthcare provider

12. Contact Information

If you have questions about this Consent, contact:

Revano Life, LLC
support@revanolife.com