Telehealth Informed Consent

Draft for counsel review · Last updated July 2026

This consent explains what it means to receive care through telehealth on the Xilo platform. You accept it during intake, before any provider interaction.

1. What telehealth is

Telehealth is the delivery of healthcare services using electronic communications: asynchronous messaging, questionnaires, at-home laboratory testing, and, where required or clinically appropriate, video visits. Your provider may be located in a different city than you, but is licensed in your state.

2. Expected benefits

• Access to hormone-health evaluation and treatment without travel or waiting rooms.
• Structured lab-first evaluation with documented baselines and follow-ups.
• Ongoing access to your care team through secure messaging.

3. Limitations and risks

• Telehealth does not include a hands-on physical examination, which can in some cases limit diagnosis. Your provider will refer you to in-person care when your case requires it.
• At-home testing is a screening method; confirmatory venous testing may be required.
• Electronic systems can fail or be delayed. For anything urgent, do not wait for a message reply; seek in-person care.
• As with all healthcare, treatment carries risks and no outcome is guaranteed. Medication-specific risks are described in the Important Safety Information and by your provider.

4. Your rights

• You may stop using telehealth services and withdraw this consent at any time without affecting your right to future care.
• You may request your records, and you may request a referral to in-person care.
• You will always be told who is treating you and their credentials.
• Consent to telehealth never waives your rights under health-privacy law.

5. Your responsibilities

• Provide accurate and complete health information; treatment decisions depend on it.
• Report side effects and new symptoms promptly.
• Use emergency services for emergencies rather than platform messaging.

6. State-specific requirements

Some states impose additional telehealth requirements, such as a synchronous video visit before prescribing. Where your state requires more, the stricter requirement applies and the platform will schedule it.

7. Questions

Ask before you consent: care@xilo.example.