Patient Services Agreement
RequiredOutlines the services we provide, your responsibilities, and important program terms.
Not Signed
✓
Purchase
2
Contracts & Consents
3
Intake
4
Labs
5
Clinical Assessment
Step 2 of 5
Review and Sign Your Clinical Documents
Before we begin your intake and lab process review and electronically sign the required documents below.
These documents protect you and ensure we can provide safe, personalized, and compliant care.
Required Documents
10-15 MINUTES
Telehealth Informed Consent
RequiredDescribe how telehealth works, its limitations, and your rights as a patient.
Not Signed
General Consent to Evaluation & Treatment
RequiredAuthorizes our clinical team to evaluate your health, order tests, and make medical recommendations.
Not Signed
Laboratory Testing Consent
RequiredCovers blood collection, testing, potential risks, and how your results are used.
Not Signed
HIPAA Notice of Privacy Practices
RequiredExplain how your health information is protected and your privacy rights.
Not Signed
Authorization to Use & Disclose Health Information
RequiredAuthorizes permitted use and disclosure of your health information where applicable.
Not Signed
Assignment & Financial Responsibility
RequiredClarifies payment responsibilities, refunds, and policies related to labs, medications, and services.
Not Signed
Your Privacy & Security are our Priority
RequiredYour data is encrypted and handled in accordance with HIPAA regulations and industry-leading security standards.
HIPAA
Compliant
SSL
Encrypted
You must review and sign all documents to continue.