Telehealth Informed Consent

This document explains what telehealth care at DonoMed involves so that you can decide whether you want it. You will be asked to agree to it during registration, and your agreement is recorded with the date and time in your patient record. You can read it here at any time, before or after you become a patient.

Who provides your care

Care at DonoMed is provided by Christopher Dono, PA-C, a physician assistant licensed in the State of Florida (license PA9113324), practicing under Florida law with physician supervision as required. DonoMed LLC provides services only to patients physically located in Florida who are 18 or older.

What telehealth means here

Telehealth is health care delivered using technology rather than an in-person visit. At DonoMed this normally means asynchronous, or store-and-forward, telehealth, which Florida expressly permits under Florida Statute § 456.47. You complete a detailed intake and submit your history, measurements, photographs, and any lab work. Your provider reviews all of it and makes clinical decisions without a simultaneous live conversation.

A live phone or video visit is available to you at any time, at no additional cost, simply by asking. Your provider may also require a live visit before prescribing if your history calls for one.

What you are agreeing to

• Your provider may evaluate you, diagnose, prescribe, and adjust treatment based on the information you submit, without an in-person or live examination.
• You will give complete and truthful information about your health history, medications, allergies, and conditions. The quality of your care depends directly on this, and incomplete information can lead to an unsafe decision.
• You are physically located in Florida and are at least 18 years old.
• Your information may be shared with the pharmacy that fills your prescription, and with other people involved in your care, as described in our Notice of Privacy Practices.

Benefits

Access to a licensed provider without travel or time off work; continuity with the same provider rather than whoever is available; and care that can be delivered from anywhere in Florida.

Risks and limitations

• Without a physical examination, a provider may miss something that an in-person visit would have found. This is the main limitation of asynchronous care.
• Information you provide may be incomplete or inaccurate, which can affect the decisions made from it.
• Technology can fail. Transmissions can be delayed, and in rare cases electronic security can be breached despite reasonable safeguards.
• Some conditions cannot be managed appropriately by telehealth. Your provider may decline to treat you remotely and refer you for in-person care. Declining to prescribe is itself a clinical decision, and it may be the right one.
• All medications carry risk. Medication-specific risks are in the Important Safety Information for each treatment, which you should read before starting.

Compounded medications

Some medications prescribed at DonoMed are compounded — prepared for you by a state-licensed compounding pharmacy pursuant to an individual prescription. Compounded medications are not FDA-approved. The FDA does not review them for safety, effectiveness, or manufacturing quality the way it reviews commercially manufactured drugs. Your provider will discuss this with you before prescribing.

Your rights

• You may withhold or withdraw this consent at any time, without affecting your right to future care.
• You may request a live phone or video visit instead of asynchronous review, at any time and at no additional cost.
• You may request a referral for in-person care.
• You may access your medical records, and request corrections to them.
• You may ask who is participating in your care at any time.

Records, privacy, and cost

Your information is documented in a secure electronic health record and handled under HIPAA. See our Notice of Privacy Practices and our Privacy Policy. DonoMed does not bill insurance; what you pay and when you pay it is described in Billing & Refunds.

Emergencies and side effects

Telehealth cannot be used for emergency care. Call 911 for an emergency. For non-urgent side effects, see Report a Side Effect.

Your agreement

By agreeing to this consent during registration, you confirm that you have read and understood it, that you have had the opportunity to ask questions, and that you consent to receive care from DonoMed by telehealth, including asynchronous telehealth.

Questions before you sign: Hello@DonoMed.com or (813) 733-8356.