Telehealth Consent

Last Updated: May 20, 2026

Trinity Healthcare Supply, LLC d.b.a. Next Meds

OUR HEALTHCARE PROVIDERS DO NOT ADDRESS MEDICAL EMERGENCIES. IF YOU BELIEVE YOU ARE HAVING A MEDICAL EMERGENCY, DIAL 911 OR GO TO THE NEAREST EMERGENCY ROOM.

BY CLICKING "I AGREE," CHECKING A RELATED BOX, 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, DO NOT CREATE AN ACCOUNT OR USE THE SERVICES.

1. CONSENT TO TELEHEALTH

Telehealth is a mode of delivering health care services via communication technologies to facilitate diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care. This Consent Form ("Consent") provides information about telehealth and obtains your informed consent to its use in the delivery of healthcare services to you by licensed healthcare professionals ("Providers") using the platform operated by Next Meds and OpenLoop Health, Inc. and its affiliated medical groups and providers (collectively, the "Platform").

In this Consent, the terms "you" and "yours" refer to the person using the Services. The term "Practice" refers collectively to the professional entities and licensed healthcare providers making services available through the OpenLoop Platform, including OpenLoop Healthcare Partners PC and its affiliated professional corporations.

This Telehealth Consent Form supplements but does not modify or supersede any Terms of Service, Privacy Policy, or Notice of Privacy Practices of Next Meds, OpenLoop Health, Inc., or other healthcare providers offering services via the OpenLoop Platform.

By indicating your consent, you confirm that you have reviewed this Consent Form, understand the risks and limitations of telehealth, have had the opportunity to ask questions, and consent to receiving services from Providers located remotely from you.

2. TREATMENT-SPECIFIC CONSENT

By accepting this Consent, you understand and agree to the following:

1. I understand that the Practice offers telehealth visits conducted through videoconferencing, telephonic, and/or asynchronous technology, and my Provider will not be physically present with me.

2. I consent to the Practice importing and accessing my medical records and medication list, including prescription records, as necessary to provide care.

3. To protect the confidentiality of my health information, I agree to undertake my telehealth visit in a private location, and I understand that my Provider will similarly be in a private location. If any other individuals are present (e.g., for technological or translation assistance), I will be informed of their presence and role, and given the opportunity to consent.

4. I understand there are potential risks to the use of telehealth technology, including but not limited to interruptions, delays, unauthorized access, other technical difficulties, data processing errors, and recording failures. I understand that either my Provider or I can discontinue the telehealth appointment if technical connections are not adequate. I AGREE TO HOLD HARMLESS THE PRACTICE, NEXT MEDS, AND OPENLOOP HEALTH, INC., TOGETHER WITH THEIR EMPLOYEES, CONTRACTORS, AGENTS, DIRECTORS, OFFICERS, AND SUCCESSORS, FOR DELAYS IN EVALUATION OR FOR INFORMATION LOST DUE TO SUCH TECHNICAL FAILURES.

5. I understand that my telehealth visit may involve the use of artificial intelligence (AI) technologies for various purposes, including but not limited to transcription of conversations, analysis of medical information, clinical decision support, quality assurance, and improvement of telehealth services. I understand that AI systems may process, analyze, and store information from my telehealth visit, including my voice and medical information. AI processing may occur in real-time and/or after my visit. Information processed by AI systems will be protected in accordance with applicable privacy laws and the Practice's privacy policies. I have the right to request information about what AI technologies are being used during my care and how my information is being processed.

6. I understand that, as part of my care, my Provider may use AI tools to assist with analyzing medical data or records, supporting clinical decision-making, generating summaries or documentation, or recommending potential diagnoses or treatment options. AI tools are intended to support, not replace, the professional judgment of my Provider. My Provider will review any AI-assisted outputs before making clinical decisions. I have the right to ask questions about how AI is used in my care.

7. I understand that my telehealth visit may be recorded (audio and/or video) for purposes including quality assurance, provider training, clinical documentation, and care coordination. I will be notified at the beginning of any session that is being recorded. Recordings may be retained in accordance with applicable laws and the Practice's retention policies. I have the right to request access to recordings of my telehealth visits, subject to applicable laws and policies.

8. I understand that in some cases, my Provider might be a nurse practitioner or a physician assistant and not a physician.

9. I understand that I could seek an in-office visit rather than obtain care via telehealth, and I am choosing to participate in a telehealth visit. I further understand that my Provider may not have access to a complete copy of my medical records and will not be able to perform an in-person examination, which could result in negative health outcomes from the recommended treatment (e.g., adverse drug interactions or allergic reactions). I understand that while telehealth may benefit me, no such benefits or specific results are guaranteed, and my condition may not improve.

10. I agree that any information I provide as part of any telehealth visit is accurate, true, and complete.

11. I understand that my Provider may determine that a telehealth visit is not appropriate for me due to my particular health concern or health status. In such a case, I will be notified and will need to seek care in another way.

12. I understand that participating in a telehealth visit is not a guarantee that I will be given a prescription, and that the decision as to whether a prescription is appropriate will be made in the professional judgment of my Provider.

13. I understand that while the Platform may make available access to certain pharmacy or diagnostic lab services, I may request to use any pharmacy or lab of my preference.

14. I understand that I am responsible for payment of any amounts due and owing resulting from my telehealth visit, in accordance with the Next Meds Terms of Service and Refund & Cancellation Policy.

15. I understand that Providers do not address medical emergencies via the Platform. In an emergency, my Provider's responsibility may be to direct me to emergency medical services, such as an emergency room.

16. I understand and agree that I give permission to Providers to use and disclose my protected health information including my entire medical record for the purpose of telehealth treatment, consistent with the Next Meds Notice of Privacy Practices.

3. AUTHORIZATION TO USE AND DISCLOSE MEDICAL INFORMATION

By accepting this Consent, I authorize Providers and the Practice to use and disclose my protected health information (including my entire medical record) for the purpose of telehealth treatment.

a. If the person or entity receiving this information is not a health care provider or health plan covered by HIPAA, the information may be re-disclosed to other individuals or institutions and therefore no longer protected by HIPAA.

b. I may refuse to agree to this authorization. My refusal will not affect my ability to obtain treatment or eligibility for health plan benefits, except where authorization is a condition of research-related treatment or enrollment in a health plan.

c. I may inspect or copy the protected health information to be used or disclosed under this authorization.

d. I may revoke this authorization in writing at any time by contacting Next Meds at care@nextmeds.com, or by emailing OpenLoop at privacy@openloophealth.com, or by mail at Trinity Healthcare Supply, LLC d.b.a. Next Meds, 3206 NE 2nd Ave, Suite 3013, Miami, FL 33137. Revocation will not apply to actions taken prior to receipt of the notice.

4. ADDITIONAL CONSENT – COMPOUNDED MEDICATIONS

The following consent applies to patients who receive a prescription from a Provider for compounded medications.

1. I understand that the FDA does not approve nor review compounded products for safety, effectiveness, or quality.

2. I understand that compounding pharmacies must adhere to strict quality control standards. Compounding pharmacies are licensed pharmacies subject to state and federal regulations.

3. I understand that safety information about prescribed compounded medications is available upon request from my Provider or the dispensing pharmacy.

5. CONSENT TO TEXT OR EMAIL COMMUNICATIONS

By accepting this Consent, I authorize Next Meds and its platform partner OpenLoop Health, Inc. to contact me via phone call, SMS/text message, or email at the contact information I have provided, for the purposes of:

• Appointment reminders
• Patient feedback requests
• General health and wellness information
• Account notifications and other communications related to my use of the Services

I understand and agree to the following:

• These communications may be generated in part by automated systems or artificial intelligence (AI).

• Standard messaging and data rates may apply.

• This authorization will remain in effect unless I revoke it in writing.

• I may opt out of receiving such communications at any time by replying STOP to any text message, following the unsubscribe instructions in any email, or contacting Next Meds at care@nextmeds.com.

• Using these communication methods presents a potential security risk of unauthorized access to protected health information (PHI). I accept this risk and consent to receiving communications through these methods.

6. PATIENT RIGHTS AND ACKNOWLEDGMENTS

By accepting this Consent, I acknowledge and affirm the following rights:

1. I have the right to withhold or withdraw my consent to telehealth at any time without affecting my right to future care or treatment.

2. The laws that protect the confidentiality of my medical information also apply to telehealth services. My health information will be protected in accordance with the Next Meds Privacy Policy and Notice of Privacy Practices, and applicable federal and state law, including HIPAA.

3. I have the right to inspect all information obtained and documented in the course of a telehealth interaction and may receive copies of this information for a reasonable cost-based fee.

4. I understand that a variety of alternative methods of health care may be available to me, and that I may choose one or more of these at any time.

5. I understand that it is in my best interest to inform my Provider of any other healthcare providers involved in my medical care.

6. I understand that telehealth is an evolving field and the use of technology in my care may include uses different from those described in this Consent. No specific results can be guaranteed; my condition may not improve or could worsen.

7. I understand that Providers may not have access to a complete copy of my medical records during a telehealth visit, which could impact the quality of care and result in adverse outcomes such as drug interactions or allergic reactions.

7. GENERAL ACKNOWLEDGMENT

My continued use of the Next Meds Services and Platform, and/or my affirmative indication of acceptance during account creation or intake, constitutes my informed consent to telehealth services, as described in this Consent Form. This Consent is hereby incorporated into the Next Meds Terms of Service by reference and constitutes a part thereof.

If you have any questions about this Consent, please contact us before proceeding:

Trinity Healthcare Supply, LLC d.b.a. Next Meds
3206 NE 2nd Ave, Suite 3013
Miami, FL 33137
Email: care@nextmeds.com
Phone: +1 855-739-9995

This Telehealth Consent Form is incorporated into the Next Meds Terms of Service and should be read in conjunction with the Next Meds Privacy Policy and Notice of Privacy Practices, available at www.nextmeds.com.