Telehealth Consent

SexyMD Telehealth Consent

Last Updated: July 7, 2026

PLEASE READ THIS INFORMED CONSENT CAREFULLY. BY SIGNING OR ELECTRONICALLY ACCEPTING THIS CONSENT, YOU AGREE TO RECEIVE HEALTHCARE SERVICES THROUGH TELEHEALTH AS DESCRIBED BELOW.

THIS CONSENT IS NOT A SUBSTITUTE FOR IN-PERSON EMERGENCY CARE. IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY, INCLUDING CHEST PAIN, A PROLONGED ERECTION LASTING MORE THAN FOUR (4) HOURS, A SEVERE ALLERGIC REACTION, OR ANY OTHER URGENT OR LIFE-THREATENING CONDITION, CALL 911 OR GO TO THE NEAREST EMERGENCY ROOM IMMEDIATELY. DO NOT USE TELEHEALTH FOR EMERGENCY CARE.

 

1. Purpose of This Consent

This Telehealth Consent (this “Consent”) describes the nature, potential benefits, potential risks, and limitations of receiving healthcare services through telehealth from a licensed healthcare provider who is employed by, contracted with, or otherwise affiliated with Jonathan Larson M.D. PC (each, a “Professional Entity,” and collectively, the “Professional Entities”), through the technology platform operated by SexyMD LLC (“SexyMD) at www.sexymd.com and through related mobile applications and services (collectively, the “Site”). This Consent supplements, and is incorporated into, the SexyMD Terms and Conditions and the SexyMD Privacy Policy. If you do not agree to this Consent, you may not receive healthcare services through the Site.

2. Definitions

“Telehealth” (also called “telemedicine”) means the delivery of healthcare services using electronic communications, information technology, or other electronic means between a healthcare provider and a patient who are not in the same physical location. Telehealth may include diagnosis, evaluation, consultation, treatment, follow-up, care management, patient education, and the exchange of healthcare data.

“Synchronous Telehealth” means real-time interaction between you and a healthcare provider, such as a live video visit, telephone call, or live text chat.

“Asynchronous Telehealth” (also called “store-and-forward telehealth”) means non-real-time exchange of information between you and a healthcare provider, such as questionnaire-based intake, secure messaging that is responded to within hours or days, or the submission of photographs, video clips, or other data that the provider reviews at a later time.

“Provider” means a licensed physician, physician assistant, nurse practitioner, registered nurse, registered dietitian, or other licensed healthcare professional who provides services to you through the Site as an employee or contractor of a Professional Entity.

“Care Team” means non-clinical staff who support your interactions with the Site and your provider, including customer-support and care-coordination personnel. The Care Team does not practice medicine and cannot give medical advice.

3. Nature of the Telehealth Services Provided Through SexyMD

Through the Site, you may receive telehealth services for the treatment categories that SexyMD makes available from time to time, which may include, among others, weight management (including evaluation for, and treatment with, glucagon-like peptide-1 (GLP-1) and dual-agonist medications such as semaglutide and tirzepatide, in either FDA-approved or compounded formulations); sexual health (including evaluation for, and treatment with, phosphodiesterase type 5 (PDE5) inhibitors such as sildenafil and tadalafil); and hair, skin, and general wellness programs (including evaluation for, and treatment with, finasteride, minoxidil, topical and oral dermatology products, and related medications and supplements).

Your specific encounters may include any or all of the following elements, depending on your state of residence, the treatment category, and your provider’s clinical judgment:

  • Electronic submission and storage of medical-history questionnaires, identification documents, biometric measurements (such as weight, height, and blood pressure), photographs (including of areas relevant to your care), laboratory results, and other healthcare data;
  • Synchronous Telehealth visits conducted by live video or telephone with a Provider;
  • Asynchronous Telehealth visits conducted by questionnaire and store-and-forward review, where permitted by applicable law and where the Provider determines that an asynchronous visit is clinically appropriate;
  • Ongoing secure messaging with the Provider and the Care Team between visits;
  • Refill assessments and dose adjustments based on your reported response, side effects, and any new clinical information;
  • Electronic prescribing of medications and routing of prescriptions to a partner pharmacy within the SexyMD Pharmacy Network for shipment to you; and
  • Use of automated, digital, and artificial-intelligence-supported tools by the Site and the Care Team to streamline non-clinical operations and present clinical information to the Provider for review.

4. Potential Benefits of Telehealth

Telehealth offers several potential benefits, including: more convenient access to a Provider without the time, cost, or travel of an in-person visit; access to clinicians and treatment options that may not be readily available in your local area; the ability to receive continuity of care while traveling within the United States; and the ability to maintain regular contact with your Provider through secure electronic messaging between visits.

5. Potential Risks and Limitations of Telehealth

Telehealth has limitations that you should understand before consenting. By signing or electronically accepting this Consent, you acknowledge that you understand and accept the following risks and limitations:

  • A Provider conducting a telehealth visit cannot perform a complete physical examination, take vital signs in person, or use diagnostic equipment that requires in-person contact. The Provider must rely on the information you provide, any photographs or measurements you submit, and information from any laboratory testing you complete;
  • Information you submit may be incomplete, inaccurate, or of insufficient quality (for example, photographs that are out of focus, lighting that obscures relevant features, or measurements that are reported incorrectly), which can affect the Provider’s ability to make a fully informed clinical decision;
  • Certain medical conditions cannot be appropriately evaluated, diagnosed, or treated through telehealth, and your Provider may determine that an in-person visit, in-person examination, laboratory test, or specialist referral is necessary;
  • Treatment provided through telehealth may, in some cases, be less effective, or take longer to achieve the desired effect, than equivalent in-person treatment;
  • Technical failures (including dropped video or audio, slow internet connections, or unavailable telehealth platforms) may interrupt a visit, delay care, or prevent care altogether;
  • Although SexyMD uses encryption and other security measures, electronic transmission of healthcare information involves a non-zero risk of unauthorized access, breach, or disclosure, including in connection with email, SMS, or other unsecured communication channels you elect to use;
  • Telehealth does not guarantee any particular clinical outcome. Individual results vary, and weight loss, sexual-health improvement, hair regrowth, dermatology results, and other treatment outcomes depend on many factors outside the Provider’s and SexyMD’s control;
  • Medications prescribed through telehealth may produce adverse effects, allergic reactions, drug interactions, or other complications, including serious complications. You must follow your Provider’s instructions, the product labeling, and any safety information provided to you, and report any adverse effect promptly; and
  • Telehealth is not appropriate for emergency or crisis care; in an emergency, you must call 911 or go to the nearest emergency room.

6. Your Right to Withhold or Withdraw Consent

Your decision to consent to telehealth is entirely voluntary. You may withhold consent and decline to receive care through the Site at any time. If you have consented and later wish to withdraw, you may do so at any time by closing your account, by telling your Provider, or by contacting SexyMD customer support at hello@sexymd.com.

Withdrawing your consent will end your access to telehealth care through the Site but will not affect any care you have already received. Withdrawing your consent will not affect your right to future in-person care or your eligibility for any benefit, program, or service to which you would otherwise be entitled.

7. Your Right to In-Person Care

You have the right to seek in-person healthcare from a provider of your choice at any time, including before, during, or after receiving telehealth services through the Site. Receiving telehealth from a Provider does not prevent you from also seeing your primary-care provider, a specialist, an emergency-department provider, or any other healthcare provider in person.

Your Provider may determine, in their independent clinical judgment, that an in-person visit, laboratory test, imaging study, or specialist referral is necessary for your care, and may decline to continue telehealth treatment if you are unable or unwilling to obtain that in-person care. In that case, your Provider will inform you, and SexyMD will, where applicable, refund the unused portion of any prepaid program fee in accordance with the SexyMD Terms and Conditions.

8. Privacy and Confidentiality

Healthcare information that you provide to your Provider through the Site is generally confidential and is protected under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and applicable state privacy laws. Your Provider’s use and disclosure of your protected health information is governed by the Notice of Privacy Practices issued by the Professional Entity that employs or contracts with your Provider, a copy of which is available on the Site.

There are limited exceptions to confidentiality required by law, including, without limitation, mandated reporting of known or suspected child, elder, or dependent-adult abuse; reporting of certain communicable diseases; reporting of credible threats of imminent serious harm to identifiable persons; and disclosures required by court order, subpoena, or other legal process. There are also limited exceptions for treatment, payment, and healthcare-operations disclosures, as further described in the Notice of Privacy Practices.

Identifiable images, video, or audio recordings of a telehealth encounter will not be disseminated to any third party without your written consent, except as required or permitted by law.

9. Recording Prohibition

You may not record any audio, video, or other communication that takes place during a telehealth visit, whether by screen recording, screenshot, separate camera, voice recorder, or any other means, without the express prior written consent of every other participant in the visit. Unauthorized recording may violate federal or state wiretap and recording laws and may result in termination of your access to the Site and other legal consequences.

10. Your Responsibilities as a Patient

In order to receive safe and effective telehealth care, you agree to the following responsibilities:

  • Provide truthful, accurate, current, and complete information at intake, during every visit, and in every refill request, including your full name, date of birth, biological sex assigned at birth, current state of residence, current physical location during each visit, contact information, complete medical and surgical history, current medications and supplements, allergies, recent or current pregnancies, hospitalizations, and any other information your Provider requests;
  • Promptly notify your Provider of any new diagnosis, new medication, change in health status, hospitalization, pregnancy or plan to become pregnant, side effect, adverse reaction, or other material change between visits;
  • Be physically located in the United States, and specifically in the U.S. state in which the Provider treating you is licensed, at the time of every telehealth visit. If you divide time between multiple states or travel, inform your Provider before each visit so that a Provider with appropriate state licensure is assigned to your care;
  • Use the Services in a private, well-lit location with a stable internet or telephone connection, and avoid conducting telehealth visits over unsecured public Wi-Fi networks or in environments where your healthcare information may be overheard or observed by unauthorized persons;
  • Follow your Provider’s instructions, the product labeling, any dosage instructions, any storage requirements (including refrigeration where applicable), and any safety guidance provided to you;
  • Promptly refrigerate or otherwise appropriately store temperature-sensitive medications upon receipt. Certain medications dispensed through the SexyMD Pharmacy Network (including, without limitation, GLP-1 medications) are temperature-controlled and may arrive in insulated cold-chain packaging. You are responsible for receiving each shipment promptly, inspecting it, and storing it per the labeled requirements. SexyMD is not responsible for loss of potency or spoilage caused by failure to follow storage requirements after delivery;
  • Use any product or medication prescribed to you only for yourself, only as directed, and only consistent with the product labeling and your Provider’s instructions; and
  • Seek in-person care promptly if your Provider so directs, if your condition worsens, or if you experience any urgent or potentially serious symptom.

11. Use of Artificial-Intelligence and Digital Tools

SexyMD and the Care Team may use software-based automation, machine-learning, and generative artificial-intelligence (“AI”) tools to support non-clinical operations, including organizing and summarizing the information you submit at intake, drafting messages for human review, supporting customer-support interactions, and personalizing your experience on the Site. Where you are directly interacting with an AI-supported chatbot, agent, or similar channel, you will be informed of that fact where required by applicable law.

SexyMD does not use AI to make clinical decisions. All clinical decisions, prescribing decisions, and clinical messages directed to you are made or reviewed by a qualified, licensed Provider exercising independent clinical judgment. You should not rely on any AI-generated content as medical advice.

12. Consent to Electronic Communications and Use of Health Information

By signing or electronically accepting this Consent, you agree that SexyMD, the Professional Entities, and your Provider may contact you and exchange healthcare information with you through the Site’s secure messaging features, email, SMS/MMS text message, push notification, and telephone call, including in connection with intake, scheduling, clinical evaluation, treatment recommendations, refills, lab results, side-effect monitoring, billing, and program updates. Such communications may include protected health information.

You understand that communications by email, SMS, or other unencrypted means are not fully secure and could be viewed by unintended persons, and you consent to such communications notwithstanding that risk. You may change your communication preferences at any time through your account or by contacting SexyMD; however, certain communications are required for the operation of the Services and cannot be opted out of (for example, billing, safety, and recall communications).

13. State-Specific Notices and Requirements

Certain U.S. states impose specific informed-consent, disclosure, documentation, modality, billing, audio-only, store-and-forward, provider-identification, or complaint-notice requirements for telehealth services. The provisions in this Section apply only to patients physically located in the indicated state at the time of the applicable telehealth encounter and only to the provider type, modality, and service line to which the requirement applies. These state-specific notices are provided in addition to, and not in place of, the rest of this Consent.

Before or during each telehealth encounter, you may be asked to confirm your identity, current physical location, contact information, emergency contact/location, consent to receive care through telehealth, and consent to the specific communication modality being used. Your Provider may determine that telehealth is not clinically appropriate or legally available for your condition, state, medication, or service type and may require an in-person evaluation, synchronous audio-video visit, additional documentation, laboratory testing, identity verification, or other steps before providing care.

13.1 California

California Business and Professions Code section 2290.5 requires that, before providing telehealth services to a California patient, the healthcare provider obtain verbal or written informed consent from the patient. By signing or electronically accepting this Consent, you provide that informed consent. You acknowledge that you have a right to receive in-person care if you prefer, that the information disclosed during your telehealth visit is generally confidential subject to the exceptions described above, and that you may withdraw consent at any time.

California also requires that physicians provide notice of the Medical Board of California, which licenses and regulates medical doctors in California. The Medical Board of California’s contact information is: Medical Board of California, 2005 Evergreen Street, Suite 1200, Sacramento, CA 95815; (800) 633-2322; www.mbc.ca.gov.

13.2 Texas

Pursuant to Texas Medical Board rules, you acknowledge that the Provider has informed you of the nature of the telehealth services to be provided, that you may seek in-person care at any time, and that complaints regarding Texas-licensed physicians and other Texas Medical Board licensees may be submitted to: Texas Medical Board, Attn: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, TX 78768-2018; 1-800-201-9353; www.tmb.state.tx.us.

You consent to receive services by telemedicine or telehealth. Your consent includes consent to treatment through telehealth, and, where applicable, consent related to data collection and data sharing required to provide your care. Your consent may be documented electronically, verbally, or in another manner permitted by applicable Texas law and professional board rules.

13.3 Florida

Pursuant to Florida Statute section 456.47 and applicable Florida Board of Medicine rules, the Provider treating you has been registered with the State of Florida (or, if Florida-licensed, is operating under their Florida license) and is held to the standard of care applicable to in-person services in Florida. You acknowledge that telehealth services in Florida are not appropriate for all conditions and that the Provider may, in their clinical judgment, require an in-person evaluation.

If you are enrolled in a weight-management program through the Site, the Florida Weight-Loss Bill of Rights (Florida Statute section 501.0575) applies; the required warnings and disclosures are provided in the SexyMD Terms and Conditions.

13.4 New York

Pursuant to New York Public Health Law sections 2999-cc through 2999-ee and applicable regulations, you have been informed of the use of telehealth, including its potential benefits and limitations, and you consent to the receipt of services by telehealth. You have the right to refuse telehealth and to be seen in person.

13.5 New Jersey

Pursuant to New Jersey Administrative Code 13:35-6B.3, you acknowledge that the Provider has obtained your informed consent to telehealth, that the Provider is licensed in New Jersey, and that you understand the nature, scope, and limitations of telehealth services.

13.6 Vermont

Pursuant to Vermont Board of Medical Practice rules, you may file a complaint regarding a Vermont-licensed physician or physician assistant at: Vermont Department of Health, Board of Medical Practice, 108 Cherry Street, P.O. Box 70, Burlington, VT 05402-0070; 802-657-4220; www.healthvermont.gov.

13.7 Other States

For information regarding state-specific informed-consent requirements, complaint procedures, or medical-board contact information for any state not listed above, please contact SexyMD at hello@sexymd.com. SexyMD operates only in U.S. states where it has the authority and licensure to do so, and the requirements in those states are applied to your care as required by applicable law.

14. Eligibility

You may consent to telehealth services through the Site only if you are at least eighteen (18) years of age, have the legal capacity to provide informed consent, and are physically located in a U.S. state in which SexyMD operates and in which your Provider is licensed at the time of each visit. SexyMD does not currently provide services to individuals under the age of eighteen (18). If you are signing or electronically accepting this Consent on behalf of another adult as that adult’s authorized agent or representative under a valid legal authority, you represent and warrant that you have that authority.

15. Relationship Between SexyMD, the Professional Entities, and Your Provider

SexyMD is a technology and administrative-services company. SexyMD does not itself practice medicine, pharmacy, or any other licensed healthcare profession, does not employ the Providers who treat you, and does not direct or control any Provider’s clinical judgment. Clinical services are provided solely by the Professional Entities and the Providers they employ or contract with. By accepting this Consent, you acknowledge that any provider-patient relationship is between you and your Provider (and, through the Provider, the Professional Entity), and not between you and SexyMD.

16. Emergencies and Limitations of the Service

TELEHEALTH IS NOT A 24/7 ON-CALL SERVICE. NON-EMERGENCY PROVIDER MESSAGES ARE TYPICALLY REVIEWED WITHIN TWO (2) BUSINESS DAYS, MONDAY THROUGH FRIDAY, EXCLUDING U.S. FEDERAL HOLIDAYS. IF YOU EXPERIENCE A MEDICAL EMERGENCY, INCLUDING (WITHOUT LIMITATION) CHEST PAIN, SHORTNESS OF BREATH, SIGNS OF STROKE, SEVERE ALLERGIC REACTION, AN ERECTION LASTING MORE THAN FOUR (4) HOURS, SEVERE ABDOMINAL PAIN, SUICIDAL THOUGHTS, OR ANY OTHER URGENT OR LIFE-THREATENING CONDITION, CALL 911 OR YOUR LOCAL EMERGENCY NUMBER AND GO TO THE NEAREST EMERGENCY DEPARTMENT IMMEDIATELY.

17. Specific Acknowledgments

By signing or electronically accepting this Consent, you specifically acknowledge and agree to each of the following:

  • You have read and understood this Consent in its entirety, or have had the opportunity to ask questions about it;
  • You have had the opportunity to discuss the nature, benefits, risks, and limitations of telehealth with your Provider or the Care Team, and any questions you raised have been answered to your satisfaction;
  • You consent to receive healthcare services from the Provider through telehealth, including both synchronous and asynchronous modalities, as the Provider determines is clinically appropriate;
  • You consent to the use of automated, digital, and AI-supported tools as described in Section 11;
  • You consent to electronic communications, including the transmission of protected health information by email, SMS, push notification, telephone, and through the Site, as described in Section 12;
  • You understand that telehealth has limitations, that no particular clinical outcome is guaranteed, and that you may be asked to seek in-person care if your condition warrants;
  • You understand and agree that telehealth is not appropriate for emergency or crisis care, and that you must call 911 or go to the nearest emergency department in any emergency;
  • You may withdraw this Consent at any time, as described in Section 6, without affecting your right to in-person care; and
  • You have the legal authority to provide this Consent for yourself (or, if applicable, on behalf of the adult patient for whom you are an authorized agent).

18. Electronic Signature and Effective Date

By typing your full legal name in the signature field, checking the consent box, or otherwise affirmatively indicating your acceptance at the time this Consent is presented to you, you are providing your electronic signature, which has the same legal effect as a handwritten signature under the federal Electronic Signatures in Global and National Commerce Act (E-SIGN), the Uniform Electronic Transactions Act (UETA) as adopted in most U.S. states, and applicable state law.

This Consent is effective on the date of your electronic acceptance and remains in effect until you withdraw it or close your account. SexyMD may amend this Consent from time to time and will provide notice of material changes by email or through the Site; your continued use of telehealth services after the effective date of an amendment constitutes your acceptance of the amended Consent.

19. Patient Signature

By electronically signing or accepting this Consent, you affirm that the foregoing has been explained to you, that you understand it, and that you voluntarily consent to receive telehealth services from a Provider through the Site.

Electronic signature: ____________________________________________

Date of acceptance: ____________________________________________

20. Contact

If you have any questions about this Consent or your telehealth care, please contact:

SexyMD LLC

5725 S Valley View Blvd, Suite 7, Las Vegas, NV 89118

Patient support: hello@sexymd.com

Privacy questions: privacy@sexymd.com

Web: www.sexymd.com

Phone (833) 3SexyMD