Telehealth Informed Consent

Last Updated: [CONFIRM EFFECTIVE DATE]

By creating an account, completing an intake form, or requesting a consultation with a clinician through LUMA+ Well Health ("LUMA+"), you acknowledge that you have read and agree to this Telehealth Informed Consent.

1. Nature of Telehealth

Telehealth involves the delivery of healthcare services using interactive electronic communications between you and a US-licensed clinician who is not physically in the same location as you. Visits on this platform are conducted asynchronously (by written intake and secure messaging) and, when clinically appropriate, by audio or video.

2. Potential Benefits

• Access to licensed clinicians without travel.
• Faster initial evaluation for non-emergent conditions.
• Discreet, private care from your home.

3. Potential Risks & Limitations

• Telehealth may not be appropriate for every condition. A clinician may determine that in-person evaluation, additional testing, or referral is required and may decline to prescribe.
• Information transmitted may be insufficient for clinical decision-making and may require follow-up. Photos, lab values, or self-reported information may be incomplete or inaccurate.
• Delays in evaluation or treatment may occur due to deficiencies or failures of equipment, connectivity, or third-party services.
• Although our systems use industry-standard safeguards, no electronic transmission of health information is ever 100% secure.

4. No Guarantee of Treatment

Submitting an intake or paying a consultation fee does not guarantee that a prescription, refill, or specific treatment will be issued. The decision is made in the independent professional judgment of the prescribing clinician. If treatment is declined, you will be notified, and any refund is handled per our Returns & Refund Policy.

5. Compounded & Off-Label Medications

Some medications offered through LUMA+ Well Health (including, but not limited to, compounded GLP-1 medications, NAD+, sermorelin, low-dose naltrexone, glutathione, and certain skincare formulations) are compounded by state-licensed 503A or 503B pharmacies and are not FDA-approved as finished drug products. The FDA has not reviewed compounded medications for safety, efficacy, or quality. Other medications may be prescribed off-label, meaning the FDA has not specifically approved the medication for the indication being treated. Off-label prescribing is legal and common in clinical practice. Your clinician will discuss the risks and alternatives.

6. Emergencies

Telehealth is not appropriate for medical emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency department.

7. Privacy & Records

Your health information will be handled in accordance with our HIPAA Notice of Privacy Practices and Privacy Policy. Visit records are maintained per applicable law.

8. State-Specific Notices

Some states require additional disclosures, consents, or patient bills of rights. By using the service, you acknowledge any state-required notices that are displayed to you during intake or at checkout.

9. Withdrawal of Consent

You may withdraw this consent at any time by discontinuing use of the service. Your decision will not affect your right to future care.

10. Physician Network Telehealth Consent

[CONFIRM LUMA PHYSICIAN NETWORK TELEHEALTH CONSENT — the affiliated professional entities that provide telehealth services to LUMA+ patients must be named here before publishing.]

11. Acknowledgement

By checking the Telehealth Informed Consent box at checkout, or by continuing to use LUMA+ Well Health services, you confirm you have read this consent, had the opportunity to ask questions, and agree to receive care via telehealth under these terms.

Questions? Contact us at hello@lumawellhealth.com.