Before you give your consent, make sure you understand how using Go-telehealth.com website ‘the website’, including web-based technologies and applications, to obtain health care differs from visiting a more traditional doctor's office.
If you have any questions, please send us a message through the website or call us at 866-691-0411.
This service is provided by HOMA DME PC, herein also referred to as Go-telehealth.com. Health services will be conducted by one of our providers licensed in your state.
NOT FOR EMERGENCIES
I understand that I should never use the Go-telehealth.com in an emergency. I understand that in an emergency, I should dial 911 or go to an emergency department.
DOCTOR-PATIENT RELATIONSHIP
I understand that the doctor has the right to refuse to take responsibility for my care if the doctor makes a professional judgment that I am not a good candidate for this service. I understand that making a request for treatment or sending a message through the website does not in and of itself create a duty of care or create a doctor-patient relationship. I understand that the doctor will take responsibility for my care only after the doctor has reviewed my request for treatment, reviewed all my information, and then subsequently determined that I am a good candidate for the telehealth services. I understand that there may be a delay until the next business day before a doctor reviews my request for treatment and any messages I send. I understand that the doctor will only assess and provide treatment for specific work and/or auto related injury(s). This is not to be construed as a complete physical examination for general health purposes. Only those symptoms which are believed to have been involved in the injury(work/auto), or that might be related to the injury, have been assessed by the examiner.
LIMITED SERVICE SCOPE
I understand that by using the website I will receive care for a limited scope of services only. I understand that by using the website I won't receive any other medical services that go beyond the services offered by Go-telehealth.com. I need to seek other sources for my other medical needs. I understand that by using the website for a telehealth consultation, I won't have an in-person consultation and physical exam that might identify a medical condition that needs further investigation or immediate treatment. I appoint Go-telehealth.com as my authorized representative for the purpose of receiving my dispensed prescription items. I understand that Go-telehealth.com may mail the prescription items directly to me through a mail order service.
GREATER RELIANCE ON INFORMATION YOU PROVIDE
I understand that by using the website I seek to enter into a relationship where the doctor relies exclusively upon information that I provide to decide whether or not the requested service is safe. I understand that the doctor has no way of verifying the information I provide and that the doctor will consider the information I provide to be accurate, true, and complete.
ADVERSE EVENTS
I understand that if I provide information that isn't true and complete, then I'll be at greater risk of adverse events from the prescribed treatment. I understand that all the information I provide when requesting a prescription, including my age, height, weight and blood pressure, are important in the doctor's determination as to whether I'm a good candidate for a particular treatment and for the service in general. I understand that adverse events can occur.
NO COMMUNICATION WITH A DOCTOR IN REAL TIME
I understand that by using the website I won't speak or message with a doctor or nurse in real time. I understand that Go-telehealth.com may not review messages until the next business day.
IMPORTANCE OF READING INFORMATION WE PROVIDE
I understand that by using the website I won't receive personalized advice on the most appropriate treatment method. I understand it is important to read the information provided within the website and via links to third-party websites for information about treatment choices. I understand that the online nature of the website requires me to read and understand the information provided about injury treatment.
RISK TO ELECTRONIC HEALTH INFORMATION
I understand that the electronic nature of the website means that there's a greater risk to the privacy of my health information compared to visiting a traditional doctor's office. I understand that although Go-telehealth.com implements a wide range of administrative, physical, and technical safeguards to protect my health information, Go-telehealth.com cannot guarantee the privacy and confidentiality of my health information.
