Menu

Informed Consent

CM Wellness
Telehealth Informed Consent

Telehealth uses secure electronic communications, information technology, and other tools to connect a healthcare provider with a patient in different locations, allowing for the exchange of personal health information for clinical care. This Telehealth Informed Consent explains the treatment methods, potential risks, and limitations of using our telehealth platform.

Services Provided:
Telehealth services offered by CM Wellness and its contracted providers (“Providers” or “your Provider”) may include patient consultations, diagnosis, treatment recommendations, prescriptions, and/or referrals to in-person care as deemed clinically appropriate (the “Services”).

TelemedWeightLoss does not itself provide clinical care. It delivers administrative, payment, and other support services for CM Wellness and its Providers.

Electronic Transmissions May Include:

  • Appointment scheduling

  • Completion, exchange, and review of medical intake forms and other relevant information (e.g., health records, images, medical device data, video or sound files, lab results) via:

    • Asynchronous communications

    • Two-way interactive audio combined with store-and-forward communications

    • Two-way interactive audio and video interaction

  • Provider treatment recommendations based on the above

  • Delivery of consultation reports including diagnosis, treatment, and/or prescription recommendations

  • Prescription refill reminders (if applicable)

  • Other electronic exchanges necessary for providing clinical care

Expected Benefits:

  • Improved access to care from your preferred location, with services available 8 hours a day, 5 days a week

  • Convenient access to follow-up care — non-emergent follow-up may be arranged by contacting your Provider directly via email

  • More efficient care evaluation and management — responses typically within 24–48 business hours, up to 72 hours on weekends and holidays

Service Limitations:

  • Telehealth does not allow for direct physical contact with the patient; certain needs may require in-person care, determined by your Provider

  • Providers do not handle emergencies — if you believe you are experiencing a medical emergency, call 9-1-1 or go to the nearest ER immediately

  • Providers supplement, but do not replace, your local primary care provider; we strongly recommend maintaining an ongoing relationship with one

  • CM Wellness does not operate any in-person clinic locations

Security Measures:
All telehealth communications occur over a secure, HIPAA-compliant connection. Systems use network and software safeguards to protect patient data from unauthorized access and maintain data integrity.

Possible Risks:

  • Delays in treatment due to technology issues or provider availability

  • Inability to communicate due to technical failures — contact CM Wellness at ***-***-**** or info@telemedweightloss.com

  • Rare situations where transmitted information is inadequate, requiring a follow-up telehealth session or in-person care

  • Rare risk of security breaches despite protective measures

Patient Acknowledgments:
By signing this consent, you understand and agree that:

  • You will have the option to choose a Provider and review their credentials before your visit, or see the next available Provider

  • Telehealth is not for emergencies; Providers cannot connect you directly to local emergency services

  • You may seek in-person care at any time instead of telehealth

  • You can withdraw consent for telehealth at any point without impacting future care rights

  • Your privacy is protected under applicable laws, and telehealth communications may involve out-of-state Providers

  • No patient images or identifiable information will be shared with researchers or educators without your consent unless required by law

  • Technical failures are possible and outside CM Wellness’s control

  • Some services (e.g., lab tests) may require visits to external facilities

  • Others may be present during your telehealth session to assist with technology, and you will be notified if so

  • Your Provider will explain diagnoses, supporting evidence, and treatment options

  • You can request a copy of your medical records from CM Wellness at: CM Wellness, 30 N Gould St Ste R Sheridan, WY 82801, Email: [email protected], PH: ***-***-****. Reasonable costs for preparation, shipping, and delivery may apply

  • You are responsible for providing complete, accurate, and current medical history. You may log into your TelemedWeightLoss patient portal anytime to review or update information

  • There is no guarantee you will receive a prescription; this is at the sole discretion of your Provider

  • You may choose the pharmacy where your prescription is sent

  • Providers may decline care if services are being misused or are not medically or ethically appropriate