Informed Consent and Authorization Agreement

Introduction:

This agreement serves to inform the user of the limitations and potential risks associated with telemedicine services provided by TeleUrgentCare. The services offered through this platform are intended for the evaluation and treatment of minor medical conditions and non-emergent chronic conditions.

Patient Authorization:

I, the undersigned patient, hereby grant TeleUrgentCare's medical team full authority and authorization to review my medical history and administer medical services to me via TeleUrgentCare's asynchronous messaging platform. I understand that the communication during the virtual visit may occur through online chat or asynchronous messaging, and that these methods are not as secure as a face-to-face encounter.

Prescription Authorization:

In granting this authorization, I authorize TeleUrgentCare to prescribe an alternative medication if my preferred or selected drug is found to be potentially harmful, unsafe, controlled, dangerous, or results in adverse drug reactions when taken in combination with my existing medication(s).

TeleUrgentCare does NOT prescribe Narcotics, Controlled Substances, certain muscle relaxants or medications requiring monitoring levels.

Conditions of Treatment:

I acknowledge and understand that TeleUrgentCare's services are only intended for the treatment of mild to moderate complexity medical conditions. I further understand that TeleUrgentCare reserves the right to cancel or refuse treatment to patients with complex or life-threatening conditions.

Follow-Up Care Obligation:

I hereby acknowledge and agree to seek follow-up care with my primary physician if my symptoms persist, or to immediately go to the nearest emergency room if my condition worsens. This obligation is binding, and I understand that failure to follow this protocol could result in serious harm to my health.

Voluntary Agreement:

I voluntarily agree to this provision as part of my treatment plan with TeleUrgentCare, and affirm that I have fully understood the terms and conditions outlined in this agreement.

Cancellation and Refund Policy:

I acknowledge and understand that I have the right to cancel my TeleUrgentCare consultation at any time prior to the transmission of my prescription to a pharmacy, and that I am entitled to a full refund in such a case. However, once the medical provider has completed my treatment plan and transmitted my prescription to the pharmacy, I understand that the consultation fee is non-refundable.

Consultation Turnaround Time:

I am aware that TeleUrgentCare strives to complete all consultations within a timeframe of 2 hours, but that turnaround time may be extended due to various reasons, including but not limited to incomplete medical data, technical difficulties, or high patient volume. In the event that I need to cancel my consultation due to such delays, I agree to do so in a timely manner. I understand that my request for a refund will not be entertained if it is submitted after the transmission of my prescription to the pharmacy.

Payment for Medication:

I understand that I still have to pay for medicine at my pharmacy, and that the consultation fee does not cover the cost of the medication. I have been informed that I may use my insurance to cover the cost of the prescription at the pharmacy.

Affirmation of Understanding:

I affirm that I have fully understood the terms and conditions outlined in this agreement, and that I am voluntarily entering into this agreement with TeleUrgentCare.

Regenerate response

.Payment Agreement ( Payment Page)**************

By completing the payment process, you acknowledge that you have read, understood, and agree to be bound by the Terms and Conditions of TeleUrgentCare related to the usage of this platform.

You hereby affirm that you are at least 18 years of age and provide your consent for services to be rendered by any healthcare provider affiliated with TeleUrgentCare, including but not limited to MDs, PAs, NPs, and DOs.

TeleUrgent Care reserves the right to decline treatment for any reasons it deems necessary, and you acknowledge and accept your right to seek alternative medical care through your primary care provider or any other healthcare provider of your choice.

Please note that due to the limitations inherent to TeleUrgent Care, the provider may only rely on the information provided by the patient and may not conduct a physical examination. Therefore, you agree to follow up with a primary care provider within 2-3 days of your telemedicine visit if there is no improvement in your symptoms or within 1 week for a formal evaluation.

By submitting payment, you authorize TeleUrgent Care to charge your credit card for the specified amount(s). No refunds will be provided for any prescription that has been sent.

TELEURGENTCARE TERMS AND CONDITIONS

Welcome to TeleUrgentCare.com (“TeleUrgentCare,” “we,” “us,” or “our”). These Terms of Service (“Terms”) govern your access to and use of our telemedicine platform, including all related services, applications, and communications. By using our services, you agree to be bound by these Terms. If you do not agree, do not use TeleUrgentCare.

1. Introduction

TeleUrgentCare PLLC provides telemedicine services to adults through its online platform, accessible via website or mobile devices. These Terms and Conditions outline the terms of use for TeleUrgentCare’s services and inform users of the limitations, potential risks, and obligations associated with telemedicine consultations.

2. Eligibility

TeleUrgentCare services are intended only for adults.
By accessing and using our platform, you represent and warrant that you are 18 years of age or older and have the legal capacity to enter into a binding agreement.
Services are currently available only to residents of Texas.

3. Services Offered

TeleUrgentCare provides telemedicine consultations for the evaluation and treatment of minor medical conditions and certain non-emergent chronic conditions.
Services are not intended for severe or life-threatening illnesses. TeleUrgentCare reserves the right to decline or cancel consultations when conditions are complex or beyond the scope of urgent care.

4. TeleUrgentCare Consultation Process

To access services, you must create an account, provide required medical information, and pay the consultation fee of $49.
Once your request is submitted, a licensed TeleUrgentCare provider will review your case and provide medical recommendations and, if appropriate, a prescription.
Consultations are generally completed within 2 hours, but processing time may vary.
Providers may prescribe alternative medications if the requested drug is unsafe, contraindicated, controlled, or otherwise deemed inappropriate.

5. Consultation Limitations

Treatment is provided based on clinical judgment without a comprehensive in-person exam. You agree to seek in-person follow-up care if symptoms persist, worsen, or fail to improve within a reasonable time.
TeleUrgentCare is not a substitute for emergency care. If you experience a medical emergency, call 911 immediately.
Communication during consultations occurs via online forms and asynchronous messaging. While safeguards are in place, you acknowledge that electronic communications may carry inherent risks, including potential unauthorized access.

6. Financial Responsibility

The consultation fee of $49 covers only the medical consultation.
Prescription medication costs are not included. You are responsible for payment at the pharmacy, though you may use insurance to cover prescription costs where accepted.
Limitations on insurance coverage or drug costs do not entitle you to a refund.

7. Medication Refund Policy

You may cancel your consultation at any time before a provider transmits a prescription to the pharmacy and receive a full refund.
Once a provider has issued a treatment plan and transmitted a prescription, the consultation fee becomes non-refundable.

8. Consultation Delays

TeleUrgentCare strives to complete all consultations within 2 hours.
Delays may occur due to incomplete information, high patient volume, or technical issues.
If you choose to cancel due to a delay, you must do so before a prescription is transmitted to the pharmacy. Refund requests submitted after prescription transmission will not be honored.

9. User Responsibilities

You agree to:

Provide complete and accurate medical information.
Use the platform only for lawful purposes.
Not misuse or attempt unauthorized access to the platform.

10. Privacy and Security

Your use of TeleUrgentCare is governed by our . By using our services, you consent to the collection, use, and disclosure of your information as described in the Privacy Policy.

11. Intellectual Property

All content, trademarks, logos, and materials on teleurgentcare.com are owned or licensed by TeleUrgentCare PLLC. You may not copy, reproduce, or distribute our materials without permission.

12. Limitation of Liability

TeleUrgentCare is not liable for any indirect, incidental, or consequential damages related to your use of the platform.
Medical care is based on the information you provide; incomplete or inaccurate information may affect treatment outcomes.
Our maximum liability shall not exceed the consultation fee you paid.

13. Indemnification

You agree to indemnify and hold harmless TeleUrgentCare PLLC, its providers, employees, and affiliates from any claims, damages, or expenses arising from your use of the services, your violation of these Terms, or your failure to provide accurate medical information.

14. Changes to These Terms

We may update these Terms at any time. Updated Terms will be posted on our website with a revised Effective Date. Continued use of TeleUrgentCare constitutes acceptance of any changes.

15. Governing Law

These Terms are governed by the laws of the State of Texas. Any disputes shall be resolved exclusively in the courts of Bexar County, Texas.

16. Contact Information

TeleUrgentCare PLLC
18756 Stone Oak Parkway, Suite 200
San Antonio, TX 78258
📧 Email: service@teleurgentcare.com
📞 Phone: +1 (210) 584-1812
🌐 Website: https://teleurgentcare.com/