Telehealth Consent & Open Payments Notice

INFORMED CONSENT REGARDING USE OF TELEHEALTH

Last updated: March 9, 2025

BY CLICKING “I AGREE,” CHECKING A RELATED BOX TO SIGNIFY YOUR ACCEPTANCE, USING ANY OTHER ACCEPTANCE PROTOCOL PRESENTED THROUGH THE SERVICE, OR OTHERWISE AFFIRMATIVELY ACCEPTING THIS CONSENT, YOU ACKNOWLEDGE THAT YOU HAVE READ, ACCEPTED, AND AGREED TO BE BOUND BY THIS CONSENT. IF YOU DO NOT AGREE TO THIS CONSENT, DO NOT CREATE AN ACCOUNT OR USE THE SERVICE. YOU HEREBY GRANT AGENCY AUTHORITY TO ANY PARTY WHO CLICKS ON THE “I AGREE” BUTTON OR OTHERWISE INDICATES ACCEPTANCE TO THIS CONSENT ON YOUR BEHALF.

IF YOU ARE EXPERIENCING A LIFE-THREATENING SITUATION SUCH AS CONTEMPLATING SUICIDE, CALL 911 OR THE NATIONAL MENTAL HEALTH CRISIS HOTLINE IN THE PHILIPPINES AT 1553.

PURPOSE: The purpose of this consent form (“Consent”) is to provide you with information about telehealth and to obtain your informed consent to the use of telehealth in the delivery of healthcare and/or mental health services to you by physicians, physician assistants, nurse practitioners, and/or mental health professionals (“Providers”) using the online platforms owned and operated by Rx Ventures Pte, Ltd. and/or its subsidiaries (the “Service”).

In this Consent, the terms “you” and “yours” refer to the person using the Service, or in the case of use by or on behalf of a minor between the ages of thirteen (13) and eighteen (18) (or the higher age of majority under applicable law), “you” and “yours” refer to and include (i) the parent or legal guardian who provides consent to the use of the Service by such minor or uses the Service on behalf of such minor, and (ii) the minor for whom consent is being provided or on whose behalf the Service is being utilized.

USE OF TELEHEALTH: Telehealth involves the delivery of healthcare and/or mental health services using electronic communications, information technology, or other means between a healthcare or mental health provider and a patient who are not in the same physical location. Telehealth may be used for diagnosis, treatment, follow-up, and/or patient education, and may include, but is not limited to, one or more of the following:

- Electronic transmission of medical records, photo images, personal health information, or other data between a patient and a provider.
- Interactions between a patient and provider via audio, video, and/or data communications (such as messaging or email communications)
- Use of output data from medical devices, sound, and video files.

Alternative methods of care may be available to you, such as in-person services, and you may choose an alternative at any time. Always discuss alternative options with your Provider.

ANTICIPATED BENEFITS: The use of telehealth may have the following possible benefits:

- Making it easier and more efficient for you to access medical care or other services and treatment for the conditions treated by your Provider(s).

- Allowing you to obtain medical care or other services and treatment by Provider(s) at times that are convenient for you.

- Enabling you to interact with Provider(s) without the necessity of an in-office appointment.

Participation in mental health services may reduce stress and anxiety, decrease negative thoughts, improve relationships, and increase comfort in different settings.

POTENTIAL RISKS: While the use of telehealth in the delivery of care can provide potential benefits for you, there are also potential risks associated with the use of telehealth and other technology. These risks include, but may not be limited to:

- The quality, accuracy, or effectiveness of the services you receive from your Provider could be limited.
- Failures of technology may impact your Provider(s)’ ability to correctly diagnose or treat your condition.
- Delays in medical evaluation/treatment could occur due to unavailability of your Provider(s) or technological failures.
- The electronic systems or security protocols used may fail, causing a breach of privacy of your medical or other information.
- Data transmitted electronically may be more susceptible to unintended disclosure of protected health information to third parties.
- A lack of access to all of your medical records may result in adverse drug interactions, allergic reactions, or other judgment errors.

LIFE-THREATENING AND OTHER EMERGENCY SITUATIONS; FOLLOW-UP CARE: If you are experiencing a life-threatening situation, such as contemplating suicide, call 911 or the Philippine National Mental Health Crisis Hotline at 1553.

If the situation is an emergency, call 911. In some situations, telehealth is not an appropriate method of care. If you require immediate or urgent care, you must seek care at an emergency room facility or another provider equipped to deliver urgent or emergent care.

Providers may not respond promptly to communications you submit through the Service. If you are not experiencing an emergency or do not require immediate or urgent care, you can communicate with Providers through the secure messaging service in the Service. If a technical failure prevents you from communicating with your Providers through the Service, you should call the following number: 911

DATA PRIVACY AND PROTECTION: The electronic systems used in the Service will incorporate network and software security protocols to protect the privacy and security of your information and will include measures to safeguard data against intentional or unintentional corruption.

Personal information that identifies you or contains protected health information will not be disclosed to any third party without your consent, except as authorized by law for the purposes of consultation, treatment, payment/billing, and certain administrative purposes. Use of the Service may include email communications to and from you that may contain protected health information. You understand that Rx Ventures Pte, Ltd. does not and cannot guarantee the security or privacy of the services you use to receive communications, including, for example, your email service provider.

LABORATORY PRODUCTS AND SERVICES: Certain healthcare services provided to you by Providers via the Service may require that you complete an at-home diagnostic test. These diagnostic tests are provided by third-party laboratories, and neither Rx Ventures Pte, Ltd. nor your Provider(s) can guarantee the accuracy or reliability of these tests.

OPEN PAYMENTS NOTICE: For informational purposes only, a link to the Philippine Food and Drug Administration (FDA) and Department of Health (DOH) web pages is provided here.

Philippines FDA: (8) 857-1900 local 1000 / (8) 842-5635 / 0961-0574926 / 0961-7709691 / 0961-6845994 or through fdac@fda.gov.ph.

The Physician Payments Sunshine Act requires that detailed information about payments and other transfers of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public. The Open Payments database is a government tool used to search payments made by drug and device companies to physicians and teaching hospitals.

YOUR ACKNOWLEDGMENTS: By clicking “I Agree,” checking a related box to signify your acceptance, using any other acceptance protocol presented through the Service, or otherwise affirmatively accepting this consent, you acknowledge and agree to the terms outlined in this Consent.

If you have a concern about a medical professional, you may contact the Professional Regulation Commission (PRC) of the Philippines regarding your concerns.

PRC Hotline: (+63) 8-310-0026

Website: www.prc.gov.ph

For additional support, contact our team via hello@andyou.ph