Telehealth Informed Consent

1. What you are agreeing to

You are requesting a telehealth consultation with an independent, licensed U.S. clinician. Telehealth means your consultation happens electronically, through the secure intake questionnaire you complete, the information and photos you submit, and secure messaging with your clinician, rather than an in-person office visit. Your consultation may be asynchronous, meaning the clinician reviews your information and responds without a live video or phone call, where state law allows. Some states require additional steps, such as a video submission, and we will tell you during signup if yours does.

2. Who provides your care

Vaylen is a technology and care-coordination platform. Vaylen is not a medical provider, does not practice medicine, and does not influence prescribing decisions. Your consultation is provided by an independent licensed clinician who holds a license in your state. Your clinician's name and credentials are shown to you in your patient portal.

If medication is prescribed, it is filled and shipped by a U.S.-licensed pharmacy that is licensed in your state. Vaylen does not compound, manufacture, or dispense any medication. The pharmacy's name appears on your prescription and medication label.

3. The professional consultation fee

A professional telehealth consultation fee applies to every visit and is included in the amount you pay at checkout. A portion of the price you pay represents this medical consult fee, which is paid to the independent clinician or clinician group. You will not be charged a separate or surprise fee for the consultation.

4. A prescription is not guaranteed

Completing checkout does not mean you will receive medication. Your clinician must review your health information and will make an independent medical judgment about whether treatment is safe and appropriate for you. Your clinician may decline to prescribe, recommend a different treatment, or ask you for more information before deciding.

5. Benefits and limitations of telehealth

Telehealth can make care more convenient and accessible. It also has limitations you should understand. Your clinician does not perform a physical, in-person examination and relies on the information you provide, so the accuracy and completeness of your answers directly affect your care. Delays in care can occur due to technology failures or connectivity issues. In rare circumstances, security protocols could fail and cause a breach of privacy, although your information is protected as described in our Privacy Policy and handled in accordance with HIPAA. If your clinician believes your needs cannot be met through telehealth, they will tell you and recommend in-person care.

You agree to provide complete and truthful information about your health history, current medications, and symptoms, and to update your clinician if anything changes during treatment.

6. Not for emergencies

Telehealth services are not for emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room. If you experience concerning symptoms while on treatment, contact your clinician through the portal, and seek in-person or emergency care when symptoms are severe.

7. Follow-up care and communication

You can message your clinician at any time through your secure patient portal, including questions about your treatment, side effects, or dosing. Periodic check-ins may be required to continue treatment, and your clinician may require updated information, labs, or photos before renewing a prescription.

8. Your rights

Your participation in telehealth is voluntary. You may withdraw this consent and stop treatment at any time by notifying your clinician or contacting support@joinvaylen.com, without affecting your right to future care. You may request a copy of your medical records. Withdrawal of consent does not undo care already provided or fees for consultations already performed, and refunds are governed by our Refund Policy and Section 4 above.

9. Acknowledgment

By checking the consent box, you confirm that:

• You have read and understood this Telehealth Informed Consent
• You consent to receive care via telehealth, including asynchronous care where permitted
• You understand a professional consultation fee applies and is included in the amount paid
• You understand a licensed clinician must review your information and may decline treatment, in which case you receive a full refund
• You are the person receiving treatment, you are at least 18 years old, and the information you provide is accurate
• You agree to the Terms of Service and have reviewed the Privacy Policy

Questions about this consent: support@joinvaylen.com