Telehealth informed consent

---

Effective Date: August 13, 2025
Last Updated: August 13, 2025

Purpose:
This consent form explains how telehealth services may be provided by a partner prescribing provider in connection with your care and the dispensing of compounded medications by Radiant Care Pharmacy. By providing your consent, you agree to receive certain healthcare services through telehealth technologies, which may include secure messaging and SMS/text communications, instead of in-person visits.

Telehealth is the delivery of healthcare services when the patient and the provider are not physically in the same location. These services may be provided via:

• Secure video conferencing
• Telephone calls
• Encrypted email and secure portal messaging
• HIPAA-compliant SMS/text messaging when appropriate and permitted by law

Telehealth may include:

• Evaluation, diagnosis, and treatment
• Review of medical history, records, and test results
• Prescribing medications, including compounded medications
• Patient education and counseling
• Remote monitoring of health information provided by you

During a telehealth appointment or exchange:

• You and the prescribing provider may communicate in real time or through asynchronous (delayed) messages, including SMS/text communications
• Your medical information may be shared electronically between you, the prescribing provider, and Radiant Care Pharmacy to coordinate your treatment
• You may be asked to confirm your identity and location at the start of the encounter
• Text-based services may include the exchange of written health questions, answers, or instructions without a video or phone call

Telehealth, including SMS/text-based services, may:

• Increase your access to healthcare without traveling to a clinic
• Provide more convenient scheduling and follow-up options
• Allow quick exchange of essential health information, prescription updates, and symptom tracking
• Support ongoing treatment plans through consistent communication

While telehealth has many benefits, there are potential risks, including:

• Technical difficulties such as poor internet connection, network outages, or device malfunctions
• Unauthorized access to information due to security failures, despite reasonable safeguards
• SMS/text messaging may not be encrypted and may be read by unintended recipients if your device is lost, stolen, or accessed by others
• Limited ability for the provider to perform a physical examination, which may affect the accuracy of diagnosis or treatment recommendations
• Possible delays in diagnosis or treatment if additional in-person care is required
• Messages may be delayed, missed, or not received if there are network issues or phone service interruptions

You have the right to:

• Refuse or withdraw your consent to telehealth, including SMS/text services, at any time without affecting your right to future care
• Request an in-person appointment instead of telehealth services (subject to provider availability)
• Ask questions and receive answers about telehealth before and during your visit
• Access your medical records as allowed by state and federal law

By consenting to telehealth, you agree to:

• Provide accurate and complete information about your medical history, medications, and symptoms
• Participate from a private and secure location to protect your confidentiality
• Protect your device with a passcode or biometric lock if using SMS/text for healthcare communications
• Notify Radiant Care Pharmacy and/or the prescribing provider immediately if your phone number changes or if your device is lost or stolen
• Understand that SMS/text-based communication is not appropriate for emergencies and may be used only for non-urgent matters unless otherwise directed
• Follow all instructions provided by your prescribing provider and Radiant Care Pharmacy regarding your care and prescribed medications
• Not record audio, video, or screenshots of telehealth interactions without express permission from all parties

Telehealth, including SMS/text-based care, is not intended for medical emergencies. If you are experiencing a life-threatening situation, call 911 immediately.

• For urgent but non-life-threatening matters, you may be directed to an emergency department or urgent care center.
• For mental health crises, call or text 988 (Suicide and Crisis Lifeline).

By providing your consent, you agree that Radiant Care Pharmacy and/or the partner prescribing provider may contact you via phone, email, secure portal, or SMS/text for:

• Appointment reminders
• Prescription updates and refill notices
• Health-related check-ins and follow-up questions
• Non-urgent care instructions

You acknowledge:

• SMS/text messaging is not encrypted and may carry some risk of unauthorized access
• You are responsible for safeguarding your own device and messages
• You can revoke your consent to SMS/text communications at any time by notifying us in writing

By proceeding with telehealth services, you confirm that you have read, understood, and agree to this Telehealth Informed Consent, including the use of SMS/text communications for certain aspects of your care.

For questions or concerns about these Terms, contact us at:
Radiant Care Pharmacy
5779 S University Dr

Davie, Fl  33328

(954)-530-4808