Telehealth Informed Consent Agreement
For Use of the Umiwell Platform Operated by Arch Healthcare, Inc.
Last Revised: November 11, 2024
Purpose and Scope of Consent
You are accessing the Umiwell platform, a technology system operated by Arch Healthcare, Inc., located at 30 N Gould St Ste R, Sheridan, WY 82801. Umiwell is a digital platform that facilitates access to healthcare services by enabling patients to connect with independent, state-licensed physicians. Arch Healthcare, Inc., through the Umiwell platform, does not provide medical services, make medical decisions, or engage in the practice of medicine. The physicians accessible through the platform are independent practitioners who are not employees or agents of Arch Healthcare. This document (“Consent”) describes the nature, risks, and limitations of telehealth services and obtains your legally valid informed consent to participate in such services using the Umiwell platform.
Definition and Nature of Telehealth
Telehealth refers to the delivery of healthcare services through electronic communication technologies, including real-time video conferencing, audio interaction, electronic transmission of medical records, and secure messaging, when the patient and the healthcare provider are not in the same physical location. Telehealth may be used for diagnosis, treatment, prescription management, follow-up care, and patient education. You understand and agree that the healthcare services made available to you through the Umiwell platform will be delivered exclusively via telehealth, and that the physician will conduct the consultation based solely on the information you provide.
Voluntary Acceptance of Terms and Consent to Telehealth
By clicking “I Agree,” by proceeding with a physician consultation through the platform, or by continuing to use any feature of the Umiwell system, you acknowledge that you have read, understood, and accepted the terms of this Consent. You affirmatively consent to the use of telehealth as the method by which you will receive healthcare services. You understand that the physicians with whom you may consult are independently licensed and exercise their own clinical judgment in determining whether telehealth is appropriate for your condition. You agree to discontinue use of the Umiwell platform for medical purposes if the physician advises that in-person care is more appropriate.
Benefits of Telehealth Services
You acknowledge that the use of telehealth may improve access to care by reducing geographic and logistical barriers. You recognize that telehealth may allow for greater flexibility in scheduling, enable remote access to consultations, and increase the efficiency of care delivery. You understand that telehealth may offer the ability to obtain medical opinions and treatment recommendations from your location without the need for in-person appointments or travel to clinical sites.
Risks and Limitations of Telehealth
You acknowledge that the delivery of healthcare via telehealth involves certain risks and limitations. You understand that the physician will not perform a physical examination and that this may limit the ability to assess your condition with full accuracy or precision. You accept that some clinical findings may be missed and that diagnostic limitations may result in delays in care, inappropriate treatment, or missed diagnoses. You understand that you may need to seek follow-up or confirmatory care in person and that the physician may advise against continuing via telehealth if your condition requires direct examination.
Technical Limitations and System Risks
You acknowledge that the use of electronic systems for telehealth services may involve technical failures, software defects, communication interruptions, or data transmission errors. You understand that such issues may impact the quality, accuracy, or timeliness of the care you receive. You accept that these risks include the possibility of incomplete transmission of medical information, system errors that render the platform temporarily inoperable or unavailable, and unintended delays in communication between you and the physician. You further acknowledge that the platform and associated technologies may include software bugs or configuration errors that could affect your care experience.
Data Security, Privacy, and Confidentiality
Arch Healthcare employs reasonable administrative, physical, and technical safeguards designed to maintain the security and privacy of your protected health information. These safeguards are intended to comply with the Health Insurance Portability and Accountability Act (HIPAA) and other applicable laws. You understand, however, that no system can guarantee absolute security, and that the transmission of data through the internet or electronic devices may expose your information to unauthorized access, inadvertent disclosure, or interception by third parties. By using the Umiwell platform, you consent to the electronic transmission of your health information and acknowledge that you may receive communications from Arch Healthcare or the physician by email, phone, or other electronic means.
Reliance on Information Provided by You
You understand that the information you provide through the Umiwell platform may be the only basis the physician has for evaluating your condition and rendering medical advice. You acknowledge that the physician may not have access to your previous medical records or care history unless you supply such records yourself. You agree that you are solely responsible for the completeness and accuracy of the information you provide and that failure to disclose material facts may result in suboptimal or inappropriate treatment. You certify that all information you submit is true, accurate, and complete to the best of your knowledge.
Scope of Consent and Ability to Withdraw
This Consent applies exclusively to telehealth services provided through the Umiwell platform and does not extend to in-person treatment or other services outside the scope of this platform. You have the right to withdraw your consent to receive services via telehealth at any time by submitting written notice to Arch Healthcare, Inc. at info@umiwell.com. You understand that such withdrawal will not affect care already provided prior to receipt of your notice and that withdrawal will result in the termination of your access to medical services through the platform, as neither Arch Healthcare nor Umiwell provides in-person care.
Prescription and Product Fulfillment
If the physician determines that a prescription is medically appropriate, the physician may transmit such prescription to a pharmacy affiliated with Arch Healthcare, Inc. for dispensing. You authorize the physician and Arch Healthcare to coordinate with the pharmacy for the purpose of delivering the product to the mailing address you have provided. You are responsible for ensuring that the address is accurate, secure, and capable of receiving deliveries. You understand that there is no guarantee that a prescription will be issued and that all prescribing decisions are made at the sole discretion of the physician based on clinical judgment.
Payment and Financial Responsibility
You acknowledge that the fees you pay to Arch Healthcare cover your use of the Umiwell platform, the coordination of the telehealth consultation, and, if applicable, the cost of prescribed products. You understand that Arch Healthcare and the physician will not bill your insurance carrier, Medicare, Medicaid, or any third-party payor, and that no reimbursement claims will be filed on your behalf. You are solely responsible for the full cost of all services and products rendered through the platform. You further understand that any care obtained outside the platform, including follow-up or emergency care, is your responsibility.
Emergency and Behavioral Health Limitations
You understand and agree that the Umiwell platform is not designed for the provision of emergency medical services or for the management of psychiatric or behavioral health crises. You acknowledge that neither Arch Healthcare nor the physicians accessible through the platform are equipped to handle life-threatening medical emergencies. If you experience a medical emergency, you agree to immediately call 911. If you are experiencing suicidal ideation or a behavioral health crisis, you are advised to contact the Suicide and Crisis Lifeline at 988. You agree not to rely on the Umiwell platform for urgent or emergent care needs.
Access to Medical Records
You understand that records relating to your telehealth consultation may be maintained as required by applicable law. You may request a copy of your records by submitting a written request to Arch Healthcare at info@umiwell.com. Records will be provided in accordance with HIPAA and applicable state privacy laws. Arch Healthcare does not retain records beyond what is necessary to support legal and compliance obligations.
Use of the Platform by Minors
If you are using the Umiwell platform on behalf of a minor between the ages of thirteen and eighteen years, or of a higher age as defined by applicable state law, you represent and warrant that you are the minor’s parent or legal guardian and that you have the legal authority to provide consent for healthcare services on behalf of the minor. You agree that both you and the minor are bound by the terms of this Consent.
Complaints and Regulatory Oversight
If you have a concern or complaint about the conduct of a physician with whom you interacted through the platform, you may contact the appropriate medical licensing board in the state where the physician is licensed. If you have a complaint regarding the pharmacy that fulfilled a prescription issued by the physician, you may contact the pharmacy licensing authority in your state. Contact information for applicable regulatory boards is available at www.umiwell.com.
Governing Law and Dispute Resolution
This Consent is governed by the laws of the State of Wyoming, without regard to conflict of law provisions. Any dispute arising under or in connection with this Consent shall be resolved exclusively in the state or federal courts located in Sheridan County, Wyoming. This Consent constitutes the full and complete agreement between you and Arch Healthcare, Inc. with respect to the subject matter herein, and supersedes all prior oral or written understandings.
Acknowledgment and Acceptance
By clicking “I Agree” or by using the Umiwell platform to initiate or complete a physician consultation, you confirm that you have read this Consent carefully, that you understand its contents, and that you voluntarily accept all terms and conditions. You confirm that you are legally authorized to enter into this Consent on your own behalf or on behalf of a minor, if applicable.