GMG Medical Group, P.A. Telehealth Informed Consent

I. Introduction

This Telehealth Informed Consent ("Consent") is made between you ("Patient," "you," or "your") and GMG Medical Group, P.A. ("Medical Group," "we," or "us"), an independently owned physician practice. GMG Medical Group provides medical services through telehealth consultations facilitated via the Gala GLP-1 platform, which provides administrative and technology services.

By using telehealth services through the Gala platform, you acknowledge that you have read, understood, and agree to the terms outlined in this Consent, in accordance with applicable state and federal laws.

II. Description of Telehealth Services

Telehealth involves the use of electronic communications (e.g., video, phone, or messaging) to enable healthcare providers at different locations to evaluate, diagnose, and/or treat patients.

Through the Gala platform, you may be connected with licensed healthcare providers affiliated with GMG Medical Group, P.A. who may recommend a course of treatment, which could include prescription medication if deemed medically appropriate.

Prescriptions, if any, are issued by a licensed provider and dispensed by a licensed pharmacy. Gala GLP-1 does not dispense medications.

III. Nature, Benefits, and Limitations

• No Physical Examination: Telehealth does not replace a full medical evaluation that might otherwise occur in an in-person setting.
• Potential Risks: These include possible delays in medical evaluation due to technology failures, information security risks, or misunderstandings arising from the lack of in-person interaction.
• Not for Emergencies: If you have a medical emergency, call 911 or go to the nearest emergency room immediately. Telehealth services are not intended for urgent or life-threatening conditions.
• No Guarantee of Prescription: Any prescription is provided solely at the discretion of a licensed provider, based on your individual medical history, symptoms, and clinical judgment.
• Results May Vary: Individual responses to any recommended treatment may vary. Testimonials or success stories do not guarantee specific outcomes.

IV. Patient–Provider Relationship

Licensed healthcare providers affiliated with GMG Medical Group, P.A. are responsible for all medical care, professional judgment, diagnoses, and treatment decisions.

Gala GLP-1 provides administrative, technology, and communication services and does not provide medical care.

V. Consent to Use Telehealth and Data Transmission

• Information Sharing: By using telehealth services, you consent to the transmission of your personal health information through secure telehealth technologies. Your information may be shared with pharmacies and other healthcare providers as necessary to coordinate your care.
• Privacy and Security: GMG Medical Group complies with applicable privacy laws, including HIPAA, to protect the confidentiality of your health information. Despite best efforts, electronic communications may carry inherent risks.

VI. Voluntary Participation and Right to Withdraw

• Voluntary Use: Your participation in telehealth services is voluntary. You may withdraw your consent or stop treatment at any time.
• Right to Seek In-Person Care: You may seek in-person medical care at any time if you prefer or if the provider determines that in-person evaluation is necessary.

VII. Acknowledgment

By proceeding with telehealth services, you acknowledge that:

• You have read and understand this Telehealth Informed Consent
• You have had the opportunity to ask questions
• You voluntarily consent to receive telehealth services from GMG Medical Group, P.A.