Your consent to receive clinical services through the BIOBYLTLABS telehealth platform.
Telehealth is the delivery of clinical care using electronic information and communication technology, where the patient and the treating clinician are in different physical locations. A telehealth encounter may include the exchange of medical intake information, the transmission of images or laboratory results, real-time audio and video consultation, the issuance of a prescription where clinically appropriate, and follow-up communication through secure messaging. This Telehealth Informed Consent (the "Consent") explains the ways clinical care is delivered through the BIOBYLTLABS LLC platform, the expected benefits and potential risks of that mode of delivery, and your rights and responsibilities as a patient. By checking the acceptance box during enrollment and continuing to a consultation, you confirm that you have read and agreed to this Consent.
BIOBYLTLABS LLC ("BioBylt Labs") is a management services organization that coordinates non-clinical administrative, technology, and support services. BIOBYLTLABS does not provide medical services and is not a party to the clinician-patient relationship. Clinical services are delivered by an independently licensed professional entity (the "Provider Group") and the individually licensed clinicians it employs or engages (each, a "Provider"). Medications prescribed through the platform are dispensed by independently licensed pharmacies (the "Pharmacy"). Each Provider will be licensed in the state in which you are located at the time of the consultation and will exercise independent clinical judgment in accordance with applicable law.
The following categories of electronic transmission may occur during your care through the platform:
Telehealth differs from in-person care in several ways that you should understand before consenting to treatment:
By accepting this Consent, I acknowledge and agree to the following:
The BIOBYLTLABS platform and the clinicians who provide care through it do not furnish emergency medical services. If you are experiencing a medical emergency — including severe chest pain, difficulty breathing, signs of stroke, severe allergic reaction, suicidal thoughts, or any condition you believe is life-threatening — call 911 or proceed immediately to the nearest emergency department. In a mental health crisis, you may also call or text 988 to reach the Suicide and Crisis Lifeline.
The federal Physician Payments Sunshine Act requires drug, device, and biologic manufacturers and group purchasing organizations to report certain payments and transfers of value made to physicians and teaching hospitals. Reported information is publicly searchable on the federal Open Payments database maintained by the Centers for Medicare & Medicaid Services (CMS) at openpaymentsdata.cms.gov. This disclosure is provided for informational purposes only. Neither this disclosure nor the existence of any payment on the Open Payments database establishes any conflict of interest or improper conduct by your Provider.
You may withdraw your consent to telehealth at any time by notifying your Provider through secure messaging or by emailing support@biobyltlabs.com. Withdrawal of consent does not affect care already provided and does not by itself cancel any scheduled medication shipment or recurring membership; see our Refund Policy and Payment & Billing Consent for how those matters are handled.
The disclosures below apply to patients who reside in or receive care while located in the states identified. Each state imposes its own combination of records-sharing rights, complaint-filing notices, and other patient-rights disclosures. Where a state in which you receive care is not specifically listed, the general protections described in Sections 1 through 9 apply.
Alaska residents have the right to receive a copy of their telehealth encounter records and to share those records with their primary care physician. Complaints about an Alaska-licensed clinician may be filed with the Alaska Division of Corporations, Business and Professional Licensing (which oversees the State Medical Board). Information on filing a complaint is available at the Division's consumer-complaints page.
Connecticut residents have the right to share copies of their telehealth encounter records with their primary care physician.
Florida residents are entitled to the protections set forth in the Florida Patient's Bill of Rights and Responsibilities, codified at Florida Statutes § 381.026. The full text is available through the Florida Senate website.
Complaints about an Iowa-licensed clinician may be filed with the Iowa Board of Medicine. Information about filing a complaint is available at the Board's consumer-resources page.
Complaints about an Idaho-licensed clinician may be filed with the Idaho Board of Medicine through its consumer complaint portal. Information is available through the Idaho Board of Medicine website.
Complaints about an Indiana-licensed clinician may be filed with the Indiana Professional Licensing Agency through its public file-a-complaint portal.
Kansas law provides that, where a Kansas patient designates a primary care or treating physician, a report of the telemedicine encounter shall be sent to that physician within three (3) days of the patient's consent to such report. If you are a Kansas resident with a primary care or treating physician you wish to share records with, please provide that clinician's name, practice, and contact information at intake or by secure message following your visit.
Complaints about a Kentucky-licensed clinician may be filed with the Kentucky Board of Medical Licensure through its grievances page.
Complaints about a Maine-licensed allopathic (M.D.) clinician may be filed with the Maine Board of Licensure in Medicine. Complaints about an osteopathic (D.O.) clinician may be filed with the Maine Board of Osteopathic Licensure.
New Hampshire residents have the right to receive copies of their telehealth encounter records and to share those records with their primary care physician or treating provider.
Ohio residents have the right to share copies of their telehealth encounter records with their primary care physician.
Complaints about an Oklahoma-licensed allopathic (M.D.) clinician may be filed with the Oklahoma State Board of Medical Licensure and Supervision. Complaints about an osteopathic (D.O.) clinician may be filed with the Oklahoma State Board of Osteopathic Examiners.
Complaints about a Rhode Island-licensed clinician may be filed with the Rhode Island Department of Health through its complaints page.
South Carolina residents have the right to control the distribution of their medical records. With your consent, your medical records may be distributed to other treating health care practitioners in accordance with applicable laws and regulations.
Consent to share records with your primary care physician. Under Texas law, with your consent, a copy of your medical records from the telehealth encounter may be transmitted to your primary care physician within seventy-two (72) hours of the encounter. If you would like your records shared with a named primary care physician, please provide that clinician's name, practice, and contact information during your intake or by secure message following the visit. If you have not designated a primary care physician, no records will be shared under this provision. Notice Concerning Complaints. Complaints against physicians and other licensees and registrants of the Texas Medical Board — including physician assistants, acupuncturists, and surgical assistants — may be reported for investigation to the Texas Medical Board at: Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018. Telephone: 1-800-201-9353. Website: [www.tmb.texas.gov]. Aviso Sobre las Quejas. Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018. Teléfono: 1-800-201-9353. Sitio web: [www.tmb.texas.gov]. Si necesita ayuda para presentar una queja, llame al número de teléfono indicado arriba. Para obtener más información, visite el sitio web de la Junta Médica de Texas.
Vermont residents have the right to receive a real-time consultation with the distant-site provider, either at the time of the initial consult or within a reasonable time thereafter. Receiving telehealth services through BIOBYLTLABS does not preclude you from receiving real-time telemedicine or in-person services with the distant provider at a future date (Vt. Stat. Ann. § 9361). Complaints about a Vermont-licensed clinician may be filed with the Vermont Board of Medical Practice or with the Vermont Board of Osteopathic Examiners.
By checking the acceptance box at enrollment and proceeding to a consultation, you acknowledge that you have read this Telehealth Informed Consent, that you have had the opportunity to ask questions, and that you voluntarily consent to receive care via telehealth on the terms described above. A copy of this Consent is available at biobyltlabs.com and upon request to support@biobyltlabs.com.