Telehealth Consent & Open Payments Notice
If you are experiencing a medical emergency, including thoughts of harming yourself or others, call 911 or your local emergency number, or dial or text 988 to reach the Suicide & Crisis Lifeline. Do not use this Service for emergencies.
By clicking “I agree,” checking a related box, or otherwise affirmatively accepting this consent, you acknowledge that you have read, understood, and agreed to its terms.
1. Purpose of this consent
This Telehealth Consent and Open Payments Notice (the “Consent”) explains the use of telehealth in the delivery of clinical care through joinaxiomhealth.com, any Axiom application, and related services (collectively, the “Service”) operated by Axiom Health, Inc. and its affiliates (“Axiom,” “we,” or “us”). It also includes notices required under federal and state law. Capitalized terms not defined here have the meaning given in our Terms of Service.
Independent licensed clinicians, physicians, advanced-practice clinicians, and where applicable mental-health professionals (collectively, “Clinicians”), affiliated with one or more medical groups, provide clinical evaluation and treatment through the Service. Axiom is a technology platform and does not practice medicine. Your clinical care is the responsibility of the Clinicians and the affiliated medical group.
2. What is telehealth
Telehealth is the delivery of health care services using electronic communications and information technology when the Clinician and the patient are not in the same physical location. Telehealth through the Service may include any of the following: electronic transmission of medical history, intake responses, photographs, and personal health information; messaging-based consultations; voice or video consultations; ordering, review, and discussion of laboratory tests; prescribing of medications, including compounded preparations and branded medications, where clinically appropriate; and follow-up communications between you and your care team.
Alternatives to telehealth, including in-person evaluation and treatment by a local clinician, are available to you. You may choose an alternative at any time.
3. Anticipated benefits
Telehealth may offer the following benefits:
- More convenient access to clinical evaluation, treatment, and follow-up;
- The ability to communicate with Clinicians at times that suit you, without an in-office visit;
- Continuity of care between visits through messaging, check-ins, and reminders; and
- Improved privacy compared with in-person waiting rooms for some sensitive conditions.
4. Potential risks
As with any clinical care, telehealth has potential risks and limitations. These include:
- The Clinician's evaluation may be limited by the absence of an in-person examination, the inability to perform certain tests, and the quality of any photos, video, or written information you provide;
- Technical issues — including bugs, latency, dropped connections, or unavailable systems — may delay, interrupt, or degrade communications or alter, distort, or lose information;
- Despite reasonable safeguards, electronic transmissions may be intercepted or accessed without authorization, which could result in disclosure of your information;
- State laws and clinical judgment may limit the conditions a Clinician can diagnose or treat by telehealth, and certain medications may not be prescribable in your state;
- If your Clinician does not have access to your full medical history, including medications, allergies, and prior care, the risk of adverse interactions or missed diagnoses increases;
- Outcomes are not guaranteed. Your condition may not improve and in some cases may worsen; and
- Mental and behavioral health treatment, when offered, can be emotionally demanding and may temporarily increase distress as therapy progresses.
5. Emergencies and limits of the Service
The Service is not intended for emergencies. If you are in a life-threatening situation, including thoughts of suicide or self-harm, call 911 or go to the nearest emergency room. Dial or text 988 to reach the Suicide & Crisis Lifeline.
Clinicians cannot be expected to respond immediately to messages sent through the Service and may not be available outside of normal business hours. Some conditions are not appropriate for telehealth or for the Service; in such cases, you may be advised to seek in-person care or to obtain a particular product or service from another provider. If you cannot reach your care team and need to communicate with us about a technical issue affecting your care, you may call our support line at [1-XXX-XXX-XXXX].
6. Privacy and security of communications
The Service uses commercially reasonable security measures to protect your information, including encryption in transit and access controls. Personal information that identifies you or constitutes protected health information will not be disclosed except as authorized by you, as required by law, or as permitted by the applicable Notice of Privacy Practices — for example, to support treatment, payment, certain administrative operations, or the limited circumstances in which mental-health providers are required to report information (such as imminent risk of harm to self or others, or suspected abuse of a child, elder, or vulnerable adult).
The Service may communicate with you by email, SMS, or in-app messaging. You acknowledge that Axiom does not control, and cannot guarantee the security of, third-party communication services you use to receive messages — for example, your email or carrier. See our Privacy Policy and Consumer Health Data Privacy Policy for further detail.
7. Prescription medications and pharmacy fulfillment
A Clinician may, in their independent judgment, determine that a prescription medication is appropriate for you. Prescribed medications may include compounded preparations made by a licensed compounding pharmacy and FDA-approved branded or generic medications dispensed by a licensed pharmacy. Compounded preparations are not FDA-approved, and statements about them on the Service have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease.
If your Clinician writes a prescription, you may be offered fulfillment through one of our pharmacy partners or may direct the prescription to a pharmacy of your choice. If you choose a pharmacy other than our partners, you will be responsible for paying that pharmacy directly. Your prescription may be filled by, and transferred between, our pharmacy partners. Not all dispensed medications are packaged in child-resistant containers; please store medications safely.
8. Laboratory services consent
If laboratory testing is part of your care, you consent to having the test ordered by a Clinician and performed by an affiliated laboratory. You understand that:
- Blood draws and similar procedures have minor risks including discomfort, bruising, bleeding, lightheadedness, and, rarely, infection at the draw site;
- Laboratory tests have inherent limitations; results may include false positives, false negatives, or inconclusive findings, and a normal result does not rule out all conditions;
- You hereby exercise your direct right under federal law to access your test results as soon as the testing report is complete, and you waive any state-law waiting period that would otherwise delay your access to results;
- Test results will be shared as needed among Axiom, the ordering Clinician, and the testing laboratory; they will not otherwise be disclosed except as authorized by you or as permitted or required by law;
- You are responsible for sharing results with your primary-care clinician and initiating follow-up where appropriate; and
- The testing laboratory, not Axiom, retains and disposes of physical specimens. Contact the laboratory with questions about specimen handling.
Laboratory testing is voluntary; you may decline at any time.
9. Cash-pay; no insurance billing
You acknowledge that the Service is cash-pay and that neither Axiom, the affiliated medical group, nor (for the services provided through the Service) the affiliated Clinicians, pharmacies, or laboratories will bill Medicare, Medicaid, any other federal or state healthcare program, or commercial insurance. You are solely responsible for amounts owed for the products and services you receive.
10. Withdrawal of consent
You may withdraw your consent to telehealth at any time, without affecting your right to receive future care from a clinician of your choice. Withdrawal will not affect any care already provided or any action taken by Axiom or the Clinicians in reliance on this Consent before they received notice of withdrawal. Affiliated Clinicians provide care only by telehealth through the Service; if you withdraw consent or otherwise need in-person care, you may need to seek services from another provider. To withdraw consent, email hello@joinaxiomhealth.com or notify your care team through the Service.
11. Acknowledgments
By accepting this Consent, you acknowledge that:
- You have read and understand this Consent and have had the opportunity to ask questions, which have been answered to your satisfaction;
- The clinical care you receive through the Service may be provided by physicians, advanced-practice clinicians, or where applicable mental-health professionals, and you agree to receive care from such non-physician Clinicians where they are acting within their license and scope of practice;
- Telehealth and the underlying technology may include errors or defects that limit functionality or affect the accuracy of records, transmissions, or results;
- Outcomes are not guaranteed, and there are limitations to diagnosing or treating any given condition by telehealth;
- Clinicians may determine that telehealth is not appropriate for your condition and that you should seek in-person care;
- You will provide truthful, accurate, and complete information, including about any care you have received or are currently receiving from other providers;
- You will not record any consultation without the express advance consent of all participants;
- Axiom has a contractual and/or financial relationship with the affiliated medical group and with our pharmacy and laboratory partners; the names of current partners may be made available through the Service or upon request, and may change from time to time; and
- You may obtain clinical care from a provider other than the Clinicians available through the Service, and you may fill any prescription at a pharmacy of your choice.
12. Open Payments Notice
The federal Physician Payments Sunshine Act (the “Sunshine Act”) requires drug, device, and biologic manufacturers to report payments and transfers of value made to certain physicians and teaching hospitals. The U.S. Centers for Medicare & Medicaid Services maintains a public database called Open Payments where this information can be searched. You can access the Open Payments database at openpaymentsdata.cms.gov.
13. Filing a complaint
If you have a concern about the professional conduct of a Clinician, you may contact the medical or behavioral-health licensing board for the state in which the Clinician is licensed.
California residents. Physicians and surgeons in California are licensed and regulated by the Medical Board of California. To verify a license or file a complaint, visit www.mbc.ca.gov or call (800) 633-2322. Marriage and family therapists, clinical social workers, professional clinical counselors, and licensed educational psychologists are regulated by the California Board of Behavioral Sciences; contact www.bbs.ca.gov or call (916) 574-7830.
14. Contact
Questions about this Consent? Contact us at hello@joinaxiomhealth.com or Axiom Health, Inc., [street address], Wilmington, DE [zip].