CONSENT TO TELEHEALTH

Blue North Medical

Effective Date: 10/23/2026

Website: https://bluenorthmedical.com/

IMPORTANT TELEHEALTH CONSENT NOTICE

PLEASE READ THIS CONSENT TO TELEHEALTH CAREFULLY BEFORE REQUESTING OR RECEIVING HEALTHCARE SERVICES THROUGH BLUE NORTH MEDICAL.

BY AFFIRMATIVELY ACCEPTING THIS CONSENT, YOU ACKNOWLEDGE THAT YOU HAVE BEEN INFORMED OF THE NATURE, POTENTIAL BENEFITS, RISKS, LIMITATIONS, AND ALTERNATIVES ASSOCIATED WITH RECEIVING HEALTHCARE SERVICES THROUGH TELEHEALTH TECHNOLOGIES.

YOU VOLUNTARILY CONSENT TO RECEIVE APPROPRIATE HEALTHCARE SERVICES THROUGH TELEHEALTH FROM AUTHORIZED HEALTHCARE PROFESSIONALS, SUBJECT TO APPLICABLE LAWS, CLINICAL REQUIREMENTS, AND THE PROFESSIONAL JUDGMENT OF YOUR TREATING PROVIDER.

YOUR CONSENT TO TELEHEALTH DOES NOT GUARANTEE THAT YOU WILL RECEIVE A PARTICULAR TREATMENT, PRESCRIPTION MEDICATION, OR MEDICAL OUTCOME.

TELEHEALTH SERVICES ARE NOT INTENDED FOR MEDICAL EMERGENCIES. IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, CALL 911 OR SEEK IMMEDIATE EMERGENCY MEDICAL ATTENTION.

1. Introduction and Purpose

Blue North Medical (“Blue North Medical,” “we,” “us,” or “our”) provides a digital healthcare platform designed to facilitate access to personalized telehealth services, clinical evaluations, and medically supervised treatment options.

The Website and related Services are operated under the Blue North Medical brand by Blue North Medical.

Through our platform, eligible patients may request healthcare evaluations and communicate with appropriately licensed or otherwise authorized healthcare professionals (“Providers”) using electronic communications and telecommunications technologies.

The purpose of this Consent to Telehealth (“Consent”) is to inform you about the use of telehealth in your medical care and to document your voluntary agreement to receive healthcare services through this method.

This Consent explains:

The nature of telehealth services.
The types of electronic communications that may be used.
The potential benefits and limitations of remote healthcare.
The risks associated with telehealth technologies.
Patient responsibilities and participation requirements.
Privacy and confidentiality considerations.
The role and responsibilities of healthcare professionals.
Your right to decline or withdraw consent to telehealth.
Important limitations regarding prescriptions and medical treatment.

This Consent is intended to supplement, not replace, any additional informed consent, medical disclosure, or treatment-specific authorization required by a healthcare professional or applicable law.

2. Definition of Telehealth

Telehealth refers to the delivery of healthcare services using appropriate telecommunications technologies when a healthcare professional and a patient are not physically present in the same location.

Under applicable Florida law, telehealth may involve synchronous or asynchronous technologies used by authorized healthcare providers for activities including medical assessment, diagnosis, consultation, treatment, patient monitoring, and health-related education.

Depending on the clinical situation and the technologies available, telehealth services may involve:

Electronic submission and review of medical intake questionnaires.
Transmission of medical histories and other relevant health information.
Secure electronic exchange of medical documents, photographs, or laboratory results.
Interactive audio or video consultations when appropriate.
Asynchronous clinical evaluations and secure messaging.
Remote discussion of symptoms, medical conditions, and treatment options.
Clinical recommendations and medically appropriate follow-up.
Electronic coordination of prescriptions with licensed pharmacies.
Communication concerning laboratory testing, diagnostic procedures, and continuity of care.

Not all communication methods constitute telehealth under every applicable law. The treating Provider will determine which methods are legally permitted and clinically appropriate for the service being delivered.

3. Description of Blue North Medical Services

Blue North Medical facilitates personalized healthcare services focused on individual health concerns, medical history, and treatment goals.

Subject to clinical eligibility and service availability, areas of care may include:

Weight Management

Clinical evaluation and medically supervised treatment options addressing weight-related health concerns.

Sexual Health

Confidential healthcare evaluations and recommendations concerning sexual health and related medical conditions.

Performance & Recovery

Individualized clinical assessments addressing concerns involving physical performance, recovery, energy, and overall well-being.

Healthy Aging & Wellness

Personalized healthcare evaluations focused on age-related health priorities, wellness, and long-term health management.

All treatment recommendations and prescription decisions are made by appropriately authorized healthcare professionals based on their independent clinical judgment.

Blue North Medical may coordinate administrative and technological aspects of the patient experience. Its role does not replace the responsibilities of the Provider delivering professional healthcare services.

4. Geographic Eligibility and Patient Location

Blue North Medical currently facilitates telehealth consultations, treatments, and prescription services exclusively for eligible patients who are physically located within the State of Florida.

By requesting or participating in telehealth services, you acknowledge and agree that:

You must be at least eighteen (18) years of age.
You must be physically located within Florida at the time healthcare services are provided.
You must accurately disclose your physical location when requested.
You must inform your Provider if your location changes before or during a telehealth encounter.
You understand that access to the Website from another state or country does not establish eligibility for medical services.
You understand that Blue North Medical or a participating Provider may decline or postpone services when your location cannot be appropriately verified or services cannot lawfully be provided.

Healthcare professionals providing telehealth services must hold the licenses, registrations, or other authorizations required under applicable law.

You may be asked to verify your identity and physical location before receiving medical care.

5. Potential Benefits of Telehealth

Telehealth may provide a convenient and accessible alternative to certain in-person healthcare services.

Potential benefits may include:

Convenient Access to Healthcare

Telehealth may allow patients to communicate with healthcare professionals without traveling to a physical medical office.

Improved Scheduling Flexibility

Remote healthcare services may offer additional flexibility for clinical evaluations and follow-up communications.

Continuity of Care

Electronic communication may support ongoing monitoring and communication between patients and their Providers.

Personalized Medical Evaluation

Providers may review relevant medical histories, symptoms, laboratory results, and other information to develop individualized recommendations.

Access to Healthcare Information

Patients may receive guidance about appropriate treatment options, preventive care, and follow-up requirements.

Coordination of Medical Services

Telehealth may facilitate administrative coordination with participating healthcare professionals, laboratories, and licensed pharmacies.

These potential benefits depend on individual circumstances, provider availability, clinical appropriateness, and the technologies used.

No specific benefit, improvement, treatment response, or medical outcome is guaranteed.

6. Potential Risks and Limitations of Telehealth

Although telehealth can be an appropriate method of delivering certain healthcare services, it also involves limitations and risks.

By accepting this Consent, you acknowledge that you understand the following potential limitations.

6.1 Limited Physical Examination

A Provider may be unable to perform a comprehensive physical examination, directly measure certain vital signs, or conduct diagnostic procedures that would otherwise be available during an in-person visit.

This limitation may affect the ability to fully assess certain conditions.

6.2 Incomplete Clinical Information

Medical information submitted through digital forms, electronic records, photographs, or remote communications may not always provide sufficient information for diagnosis or treatment.

A Provider may request additional information, laboratory testing, diagnostic procedures, or an in-person evaluation before making clinical decisions.

6.3 Technology and Communication Failures

Internet disruptions, software problems, equipment malfunctions, or other technical failures may interrupt or delay a telehealth encounter.

Such failures may affect the timely transmission or receipt of medical information.

6.4 Privacy and Security Risks

Electronic communications may involve risks associated with unauthorized access, interception, improper disclosure, or technical security incidents.

Appropriate privacy and security safeguards must be maintained by the responsible organizations, but no technology can completely eliminate all potential risks.

6.5 Delayed Recognition of Medical Conditions

Certain medical conditions may be more difficult to identify remotely.

A Provider may not be able to recognize all relevant physical findings or clinical complications without additional testing or in-person evaluation.

6.6 Limited Treatment Availability

Not every condition can be appropriately evaluated or treated through telehealth.

Some medications, procedures, and clinical services may require an in-person examination or may be subject to legal or prescribing restrictions.

6.7 Uncertain Treatment Outcomes

As with other healthcare services, treatment outcomes may vary.

Symptoms or medical conditions may remain unchanged, fail to improve, or worsen despite appropriate evaluation and treatment.