Consent To Telehealth Services

This Consent to Telehealth Services (“Consent to Telehealth”) should be read in conjunction with the Terms and Conditions of Use for the website of which it forms part (the “Terms”). In this Consent to Telehealth, the terms “you” and “yours” refer to the person using the telehealth service, or in the case of a use of the service by or on behalf of a minor, “you” and “your” refer to include (i) the parent or legal guardian who provides consent to the use of the telehealth services 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. The purpose of this form is to obtain your consent to participate in Klarity's telehealth services.

What is Telehealth?

Telehealth allows you to visit with a healthcare provider remotely using a phone, computer, or tablet. You do not need to go to a clinic or hospital.

Telehealth may include:

• Electronic transmission of medical records, photo images, personal health information, or other data between you and a healthcare provider.

• Interactions between you and your healthcare provider via audio, video, and/or data communications.

• Use of data from medical devices, sound, and video files.

Possible Benefits of Telehealth

• Easier and more convenient access to medical care and treatment.

• Ability to receive care without traveling to a provider's office.

• Reduced exposure to illnesses that may be present in clinics or hospitals.

Possible Risks of Telehealth

• The provider may not be able to perform certain in-person tests, which may impact medical decision-making.

• Telehealth services may not be suitable for all medical conditions, and in some cases, an in-person visit may be necessary.

• There may be technical difficulties, such as poor internet connection, that could interrupt or delay care.

• Privacy and security risks, including the possibility that transmitted information could be intercepted despite security measures.

Will My Telehealth Visit Be Private?

• Klarity Health will not record your visits with a provider.

• You should be in a private space to prevent others from overhearing your conversation.

• Your provider will inform you if anyone else is present during your telehealth visit.

• We use secure telehealth technology to protect your privacy, but no system is entirely risk-free.

Your Rights

• You may withhold or withdraw your consent to telehealth at any time without affecting your right to future care or treatment.

• You have the right to access and review your telehealth records as permitted by law.

• You may request an in-person visit if telehealth is not appropriate for your condition, though this may not always be immediately available.

How Much Does a Telehealth Visit Cost?

• The cost of telehealth services depends on which practice you choose, and if you choose to use insurance.

• A telehealth visit will not cost more than an in-person visit.

• If your provider determines that an additional in-person visit is necessary, you may be responsible for both visits.

What If I Change My Mind About Telehealth?

• You can stop using telehealth services at any time, including during a visit.

• If you no longer want to use telehealth, you can notify Klarity via email at patientsupport@helloklarity.com,

• If you stop using telehealth, you may still receive in-person care when available.

Acknowledgment and Consent

By continuing to use Klarity Health's platform and services, you are accepting this Consent to Telehealth. You acknowledge that you understand and agree to the following:

• Telehealth involves the remote delivery of healthcare services, including assessment, treatment, diagnosis, and education, using electronic communication technologies.

• You have read and understand the risks and benefits of telehealth as described above.

• You voluntarily give informed consent for the use of telehealth by providers affiliated with Klarity.

• You understand that your provider may determine that telehealth is not suitable for your condition and may recommend in-person care instead.

• You have the right to withdraw your consent at any time without affecting your future healthcare.