Telehealth Informed Consent

This document explains how care is delivered at Titan Medical Center and asks for your informed consent to receive telehealth services. Please read it carefully before you begin your evaluation.

1. The telehealth model

Treatment requires a synchronous live video consultation with a licensed provider. The online intake gathers information only; no prescription is issued based on the questionnaire alone. These consultations are conducted by a provider licensed in Florida, in accordance with Florida telehealth law (Fla. Stat. § 456.47).

2. Identity verification

The patient presents a valid government-issued photo ID during the live video consultation and the provider visually confirms identity on camera.

3. Risks and limitations of telehealth

Telehealth has benefits and limitations. Because your provider cannot physically examine you, there is a possibility that information available through video and your intake may be insufficient to make a diagnosis or to prescribe safely, in which case your provider may decline treatment or ask you to be seen in person. Technical problems may interrupt a visit. As with any medical care, treatment is not guaranteed to be effective, and side effects are possible. Your provider will discuss the specific risks of any recommended treatment with you.

4. Your right to decline or discontinue care

You may discontinue telehealth services at any time and seek care from an in-person provider of your choice.

5. Controlled substances

Some hormone treatments are controlled substances. Testosterone is a Schedule III controlled substance under federal law and the law of the State of Florida.

• It is prescribed only by a DEA-registered licensed provider, and only after a synchronous live video evaluation. Florida permits the prescribing of Schedule III through V medications by telehealth (Fla. Stat. § 456.47).
• Before issuing any controlled-substance prescription, the provider reviews the patient's history in Florida's Prescription Drug Monitoring Program (E-FORCSE), as required by Florida law (Fla. Stat. § 893.055).
• Conservative quantity limits apply. There are no automatic refills; each refill requires a follow-up evaluation with your provider.

6. Consent acknowledgment

By submitting your clinical intake and consenting during scheduling, you acknowledge that you have read and understood this consent, and that you agree to our Terms of Service, our Privacy Policy, and our HIPAA Notice of Privacy Practices. Your consent is recorded with a timestamp at the time of submission.