Medical Disclaimer
Patient agrees to the virtual e-visit service terms, privacy policy, and applicable charge for receiving a virtual visit with a Feel Ideal 360 provider.
After reviewing your information, or during the e-visit, it may be determined that your concern is too complex for a virtual visit. In that case, our office may recommend scheduling a traditional in-office visit. If applicable, your e-visit fee may be applied to the patient balance related to your office visit.
Communication during an e-visit may be exchanged by teleconference, landline phone, cellular phone, secure messaging, or online communication as permitted by the State of Texas. By requesting an e-visit, you acknowledge that personal health information may be communicated electronically.
All pertinent communication related to the e-visit encounter will be documented in the patient’s medical/health record and made available upon appropriate request.
During the virtual e-visit, your Feel Ideal 360 provider may make recommendations, provide medical advice, and/or prescribe, refill, or recommend medications when medically appropriate. Your provider may also recommend additional care, examination, testing, or treatment at an in-person medical facility. If necessary, your provider may recommend that you seek care in an emergency room. Any additional care, tests, or examinations will be at the sole cost of the patient.
As with any medical service or treatment, there are risks. Because an e-visit is electronic and not performed in person, the patient acknowledges that certain risks may be greater than with a traditional office visit. By requesting the visit, the patient agrees to accept the outcome, even if it is undesirable. In the event of an undesired outcome, the patient releases the provider and clinic from liability to the fullest extent permitted by law.
Your Feel Ideal 360 provider may prescribe a variety of treatment options tailored to your individual needs. These may include topical, oral, transdermal, or subcutaneous pellet therapies. Some treatments may be used off-label, meaning they are not specifically approved by the FDA for that particular use. By proceeding with treatment, you acknowledge that you have been informed of this and consent to the use of such therapies as part of your personalized care plan.
If you cancel your telemedicine appointment within the 48-hour cancellation period, please be aware that a 3% processing fee may apply to your refund.
I acknowledge that I am paying for a telemedicine consultation with a Feel Ideal 360 provider and that the outcome will be based solely on the provider’s medical discretion. I understand that the fee is non-refundable unless otherwise stated by Feel Ideal 360 policy.
In addition, I agree to abide by Feel Ideal 360’s routine office policies, including any policies related to litigation.