This Telehealth Informed Consent describes the nature of telehealth services provided through QIM Health, the associated benefits and risks, and your rights as a patient. Please read it carefully before your first consultation.
1. Introduction and purpose.
QIM Health provides health optimization services through telehealth technology. Informed consent is both a legal requirement and an ethical standard that ensures you have the information necessary to make autonomous decisions about your healthcare. By electronically acknowledging this Consent, you confirm that your agreement is voluntary, informed, and freely given.
2. What is telehealth?
Telehealth is the delivery of healthcare services using electronic communications including audio-video platforms, telephone consultations, and secure messaging when the patient and provider are not in the same physical location. Services delivered through QIM Health may include live video consultations, asynchronous communications, remote laboratory result review, prescription management, health coaching, and AI-enhanced features.
3. Nature and scope of telehealth services at QIM Health.
Services Delivered via Telehealth
- Initial consultations and comprehensive health history reviews;
- Laboratory result review and interpretation;
- Biomarker assessment and trend analysis;
- Health optimization protocols and personalized treatment plans;
- Follow-up consultations and protocol adjustments;
- Therapeutic discussion and patient education;
- Pharmacy coordination and prescription management.
Services NOT Delivered via Telehealth
- Emergency care or urgent care services;
- Hands-on physical examinations;
- Crisis mental health intervention;
- Continuous physiological monitoring;
- Substitution for primary care or specialist in-person care when clinically required.
4. Benefits of telehealth.
- Convenient access to specialized health optimization expertise without travel;
- Continuity of care with a consistent, dedicated provider over time;
- Rapid integration of laboratory results directly into your care plan;
- Access to specialized expertise not always available locally;
- Reduced exposure to communicable illness in clinical settings;
- Greater privacy for sensitive health discussions;
- Efficient follow-up and protocol adjustments without scheduling delays.
5. Risks and limitations of telehealth.
5.1 Clinical Limitations
Telehealth does not include physical examination. Clinical recommendations depend substantially on information you self-report. Telehealth is not appropriate for all conditions, and your Provider may determine that an in-person evaluation is necessary.
5.2 Technology Risks
Telehealth services depend on internet connectivity and functioning devices. QIM Health is not responsible for service interruptions caused by technology failures outside its control. No electronic platform can guarantee 100% security against unauthorized access.
5.3 Privacy Risks
Participating in a telehealth session from a non-private location may expose your health information to others nearby. You should use a secure, private Wi-Fi connection and manage your physical environment to protect your confidentiality during consultations.
5.4 Prescribing Limitations
Prescription of medications is subject to federal and applicable state law, including the Ryan Haight Online Pharmacy Consumer Protection Act for controlled substances. Your Provider retains clinical discretion and may decline to prescribe any medication, including based on telehealth-specific regulatory requirements.
5.5 Response Time Limitations
QIM Health does not guarantee specific response times for asynchronous communications. Secure messaging and portal communications are not appropriate channels for urgent or emergent medical matters.
6. Patient rights in telehealth.
As a QIM Health patient, you have the right to:
- Refuse or withdraw consent to telehealth at any time without penalty;
- Request information about in-person care alternatives;
- Privacy and confidentiality of your health information under HIPAA;
- Access your medical records and request amendments;
- Ask questions and receive answers before agreeing to any treatment;
- Seek a second opinion from another provider;
- Know the name, credentials, and licensure status of your treating Provider;
- File a complaint with QIM Health or with your state’s medical licensing board.
7. Patient responsibilities.
To receive safe, effective telehealth care, you agree to:
- Provide accurate, complete, and current health information to your Provider;
- Promptly disclose any changes in your health, medications, or circumstances;
- Participate from a private location during consultations;
- Use a functional device with a stable internet connection;
- Attend scheduled appointments or provide advance notice of cancellations;
- Follow laboratory collection instructions and attend scheduled lab appointments;
- Review all portal communications, results, and care plan updates in a timely manner;
- Never use the QIM Health platform to report or seek care for a medical emergency;
- Seek in-person care when your Provider or the clinical situation directs you to do so.
8. Recording of telehealth sessions.
Telehealth sessions may be documented in written clinical notes for purposes of clinical documentation and quality assurance. Audio or video recording of consultations by QIM Health is conducted only in compliance with applicable state law and with appropriate notice. All recorded content is stored in a HIPAA-compliant manner. You may not record any telehealth session without obtaining prior written consent from your Provider.
9. Privacy, confidentiality, and HIPAA.
QIM Health complies with the Health Insurance Portability and Accountability Act (HIPAA). Our Notice of Privacy Practices describes in detail how your Protected Health Information (PHI) may be used and disclosed. All data transmitted during telehealth sessions is protected using TLS encryption. Third-party platform vendors with access to PHI are required to execute Business Associate Agreements (BAAs). Our full Privacy Policy is available at www.qimhealth.com.
10. Laboratory diagnostics in the telehealth context.
Laboratory tests are ordered by your independent licensed Provider based on clinical judgment. QIM Health partners with Quest Diagnostics for specimen collection at locations nationwide. You are responsible for scheduling and attending your laboratory collection appointment. Results are delivered to your patient portal and reviewed by your Provider. QIM Health does not guarantee specific turnaround times for laboratory results. Critical values require timely Provider follow-up — you are responsible for maintaining current and accurate contact information in your patient portal.
11. Prescriptions and treatment protocols.
All prescriptions are issued solely by your independent licensed Provider. Prescribing is subject to federal and applicable state law, including the Ryan Haight Online Pharmacy Consumer Protection Act for controlled substances. QIM Health does not guarantee that any specific medication will be prescribed. Pharmacy fulfillment is performed by independent third-party pharmacies. You are required to provide full disclosure of all current medications, supplements, and health conditions. Any off-label medication use will be explained to you by your Provider before prescribing.
12. AI-enhanced features and digital health tools.
QIM Health may offer AI-enhanced features, including educational health content, biomarker trend summaries, and protocol suggestions. These features are for educational purposes onlyand do not constitute medical diagnosis or treatment recommendations. AI tools have known accuracy limitations and are not a substitute for clinical judgment. Where AI outputs are clinically relevant, they are reviewed under Provider oversight. Third-party AI technology vendors are required to meet QIM Health’s data protection standards.
13. Emergency procedures.
You agree never to use the QIM Health platform, patient portal, or messaging system to report or seek care for a medical emergency. You agree never to delay seeking emergency care because of your use of QIM Health services. QIM Health is not an emergency service and cannot dispatch emergency responders.
14. State-specific telehealth requirements.
QIM Health complies with all applicable state telehealth laws, including informed consent requirements, provider registration and licensure obligations, and standards of care for telehealth delivery. Telehealth services may not be available in all jurisdictions. State medical boards retain oversight authority over Providers practicing telehealth within their jurisdiction. This Consent is governed by the laws of the State of Michigan to the extent not superseded by applicable federal law or the law of the jurisdiction in which you are located.
15. Financial terms and insurance.
Payment in full is required prior to scheduling telehealth services. QIM Health does not bill insurance carriers directly. Membership fees and service fees may be non-refundable once services have been delivered, as described in your Patient Agreement. You are solely responsible for the cost of third-party services including laboratory fees, pharmacy charges, and any other provider services not included in your QIM Health membership.
16. Limitation of liability and assumption of risk.
QIM Health and its affiliates, officers, employees, Providers, and agents (collectively, “QIM Parties”) shall not be liable for any indirect, incidental, consequential, or punitive damages arising from your use of telehealth services. You acknowledge and assume the inherent risks and limitations of telehealth delivery as described in this Consent. To the maximum extent permitted by applicable law, the total liability of the QIM Parties for any claim arising from telehealth services shall not exceed the total fees paid by you to QIM Health in the six months preceding the claim.
17. Withdrawal of consent.
Your participation in telehealth is entirely voluntary. You may withdraw this Consent at any time by emailing support@qimhealth.com. Withdrawal does not affect services already delivered or fees already incurred. Upon withdrawal, QIM Health will assist you in transitioning your care and obtaining referrals to in-person providers as appropriate.
18. Acknowledgement of understanding.
By electronically acknowledging this Consent, you confirm that you have:
- Read this entire Telehealth Informed Consent in full;
- Understand what telehealth is and how QIM Health delivers services through it;
- Understand the benefits, risks, and limitations of telehealth described above;
- Understand that telehealth is not appropriate for emergencies and that you will call 911 in a medical emergency;
- Understand that Providers delivering services through QIM Health are independent licensed professionals;
- Understand that AI-enhanced features are for educational purposes only and do not constitute medical advice;
- Understand that you may withdraw this Consent at any time;
- Had the opportunity to ask questions prior to consenting; and
- Voluntarily consent to the delivery of healthcare services via telehealth as described in this document.
QIM Solutions LLC dba QIM Health
Email: support@qimhealth.com