Informed Consent for Telehealth Services

Last updated: April 9, 2026

This informed consent explains how Midlife Women-supported telehealth services may work, what the material benefits and limitations are, what you are agreeing to by moving forward, and when in-person care may be more appropriate.

I. Nature of Telehealth

Telehealth involves the delivery of healthcare services using electronic communications, information technology, or other means between a healthcare provider and a patient who are not in the same physical location. This may include assessment, diagnosis, consultation, treatment, education, care management, and self-management.

Telehealth on Midlife Women may include asynchronous questionnaires, secure messaging, image or document review, audio or video encounters, prescription review, and coordination with pharmacies or laboratories.

II. Expected Benefits of Telehealth

• Access to menopause-specialized clinicians regardless of location
• Reduced wait times compared to in-person specialist visits
• Convenience of asynchronous or real-time communication
• Evidence-based care informed by current clinical research

III. Risks and Limitations

• Technology failures may interrupt or prevent service delivery
• Physical examination is not possible via telehealth
• Your clinician may determine that telehealth is not appropriate for your condition and may refer you to in-person care
• Electronic communications carry a risk of interception, although we use encryption to protect your information

Additional limitations may include incomplete history, delays caused by connectivity or response times, difficulty assessing urgent symptoms, and state-based prescribing rules that limit what can be provided remotely.

IV. Alternatives to Telehealth

Alternatives include obtaining care in person from your primary care clinician, OB-GYN, menopause specialist, urgent care, or emergency department depending on the urgency and nature of your symptoms.

V. Your Rights

• You have the right to withdraw consent at any time
• You have the right to refuse any recommended treatment
• You may request an in-person visit at any time
• Your information will be protected per our Privacy Policy and your clinician's Notice of Privacy Practices

VI. Your Responsibilities During Telehealth

• Provide accurate, complete, and current health information
• Update your clinician if your symptoms, medications, or risk factors change
• Use a private setting when possible to protect your confidentiality
• Maintain access to a reliable device, internet connection, and current contact information
• Seek emergency or in-person care when your symptoms require it

VII. Prescriptions and Clinical Decision-Making

Medication, if prescribed, will be prescribed by your licensed clinician based on their independent medical judgment. A prescription is not guaranteed. Controlled substances may have additional prescribing requirements and limitations.

Your clinician may decide that medication is not appropriate, that additional testing is needed, or that an in-person examination is required before treatment can continue.

VIII. Privacy, Records, and Communications

Telehealth encounters may be documented in your medical record and may involve the electronic transmission of information to clinicians, pharmacies, labs, and support vendors involved in your care or service coordination. Midlife Women uses safeguards designed to protect your information, but no transmission system can be guaranteed to be entirely secure.

IX. Emergency Situations

Telehealth is not intended for emergency situations. If you experience a medical emergency, call 911 or go to your nearest emergency room.

Symptoms that may warrant urgent or emergency evaluation can include chest pain, severe shortness of breath, stroke-like symptoms, severe bleeding, thoughts of self-harm, or any rapidly worsening condition.

X. Consent

By using Midlife Women's services and completing the intake process, you consent to receiving healthcare services via telehealth. You acknowledge that you have read and understand this consent form.

You further acknowledge that telehealth may not be the same as an in-person visit, that you have had the opportunity to review this consent before proceeding, and that you may stop using the service if you prefer to seek care in another setting.