Consent for Telehealth Services

Thank you for choosing A New You Body & Mind LLC D/B/A The Re-Movement. We make available to individuals who register as users of the Service (“Users”) certain products and services sold or offered by A New You Body & Mind LLC D/B/A The Re-Movement or by third party medical providers, pharmacies, or other vendors via our Service. Our Service provides access to prescription fulfillment services offered by the third-party pharmacies (the “Pharmacies”) and, from time to time, may offer laboratory services from 3rd party laboratories (the “Labs”). You agree and understand that your prescription(s) may be filled by and transferred between any of the Pharmacies, and agree that the Service may do so on your behalf. We may also provide you with access to third party Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatments, such as The Re-Movement, who provide healthcare services through the Platform (the “Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatments”). These Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatments employ or contract with physicians who offer certain healthcare services through the Platform (“Providers”). By accepting this Agreement, you acknowledge and agree that any services you receive from the Labs, Pharmacies, Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatments or Providers through the Platform are also subject to this Agreement, and that the Labs, Pharmacies, Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatments and Providers are third party beneficiaries of this Agreement.

You are viewing this form because you have elected to engage in asynchronous telemedicine visits with Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatment.'s healthcare practitioner. Your practitioner is a board-certified physician licensed in your state.

By clicking “I Agree,” I ACKNOWLEDGE I HAVE READ AND UNDERSTAND THE "Terms of Use" LISTED ON THE SITE AND THE TERMS PRESENTED BELOW, AND UNDERSTAND THE RISKS AND BENEFITS OF ASYNCHRONOUS TELEMEDICINE, AND BY ACCEPTING THESE TERMS OF USE I HEREBY GIVE MY INFORMED CONSENT TO PARTICIPATE IN ASYNCHRONOUS TELEMEDICINE UNDER THESE TERMS.

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What is Telemedicine?

Telemedicine is the delivery of healthcare services, including examination, consultation, diagnosis, and treatment, through electronic communication technologies when you (the Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatment.'s patient) are located in a different location than your healthcare practitioner.

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What is Asynchronous Telemedicine?

Asynchronous telemedicine is one way to deliver telemedicine. Asynchronous communication is often referred to as “store-and-forward” communication, where participants submit and collect data at different times.

“Asynchronous” means “not occurring at the same time” and is different from “synchronous” telemedicine, which generally includes visits conducted in real-time between patients and healthcare practitioners through audio or video means (e.g., live phone calls or video-conferencing).

Healthcare practitioners may use asynchronous telemedicine to aid in diagnoses and medical consultations when live communication or face-to-face contact is not possible or necessary.

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What are the Possible Risks to Using Asynchronous Telemedicine?

As with any medical treatment, there are potential risks associated with the use of asynchronous telemedicine. Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatment. believes that the likelihood of these risks materializing is very low.

• Delays in medical evaluation and consultation or treatment may occur due to deficiencies or failures of the equipment or the Internet, which may include poor data quality, Internet outages, or other service interruption issues. You may reschedule the visit with your healthcare practitioner should these interruptions occur.
• Security protocols could fail, causing a breach of privacy of personal medical information.
• Because Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatment. does not have access to your complete medical records, if you do not disclose to your healthcare practitioner a full list of your medical history including diagnoses, treatments, medications/supplements, and allergies, adverse treatment, drug interactions or allergic reactions, or other negative outcomes may occur.
• Because Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatment. does not have access to your complete medical records, if you do not disclose to your healthcare practitioner a full list of your medical history including diagnoses, treatments, medications/supplements, and allergies, adverse treatment, drug interactions or allergic reactions, or other negative outcomes may occur.
• Asynchronous telemedicine services are NOT emergency services and your personal data WILL NOT BE MONITORED 24/7. If you think you are experiencing a medical emergency, CALL 911 IMMEDIATELY. THE CARE YOU RECEIVE WILL BE AT THE SOLE DISCRETION OF THE HEALTHCARE PRACTITIONER WHO IS TREATING YOU, WITH NO GUARANTEE OF DIAGNOSIS, TREATMENT, OR PRESCRIPTION. THE HEALTHCARE PRACTITIONER WILL DETERMINE WHETHER OR NOT THE CONDITION BEING DIAGNOSED AND/OR TREATED IS APPROPRIATE FOR THE CARE PROVIDED THROUGH AN ASYNCHRONOUS TELEMEDICINE ENCOUNTER VIA THE PLATFORM.

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Your Rights and Acknowledgements:

• You have the same privacy rights via asynchronous telemedicine that you would have during an in-person visit.
• Asynchronous telemedicine may involve electronic communication of your personal medical information to healthcare practitioners who may be located in other areas, including out of state.
• You understand that you may expect the anticipated benefits from the use of asynchronous telemedicine, but that no results can be guaranteed or assured.
• You understand that all information submitted to Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatment. via text message and entered by your healthcare practitioner in the Independent third-party licensed healthcare providers not affiliated with A New You Body & Mind LLC D/B/A The RE-Movement, who are solely responsible for all clinical decisions, diagnosis, and treatment. Platform will be part of your medical record and available to you.
• You understand that your healthcare practitioner’s initial text message to you will include his/her name and credentials.
• You understand you may withdraw your consent and delete your patient profile at any time by emailing [email protected].
• You understand that your healthcare information may be shared in accordance with applicable laws.
• When a valid court order is issued for medical records.
• Reporting suspected abuse, neglect, or domestic violence.
• Preventing or reducing a serious threat to anyone's health or safety.

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Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

If you have any questions about this notice or need further information, please contact our Privacy Officer at [email protected].