Telehealth Informed Consent

Effective date: October 30, 2026

Version 1.0

This Telehealth Informed Consent explains how telehealth care works, what it can and cannot do, and your rights. Please read it carefully. By checking the consent box or otherwise indicating your agreement, you agree to this document.

You can read or print this document at any time at https://my.myorbithealth.com/legal/informed-consent.html, or ask us for a copy at hello@myorbithealth.com.

1. Who provides your care

Your medical care is provided by the independent medical practices in the MyOrbit Health provider network. These are professional medical corporations and groups that provide care through the MyOrbit Health platform. In this document, "the Practice" means the practice whose licensed provider reviews your intake or sees you. "We" and "us" mean the Practice, and MyOrbit Health, Inc. when it acts on the Practice's behalf. You may request the name of the Practice that provided your care at any time.

Your provider may be a physician, nurse practitioner, or physician assistant licensed in your state. Nurse practitioners and physician assistants practice under the supervision of, or in collaboration with, a physician as your state requires. You will be told your provider's name and credentials, and you may ask for their license number and the state that issued it.

You may have found us through a brand, website, or app. In this document we call it "the brand through which you ordered." That brand does not practice medicine and does not make medical decisions about you. Only a licensed provider of the Practice decides whether treatment is right for you.

MyOrbit Health, Inc. provides the technology and administrative platform used for your intake, checkout, patient portal, and visits. MyOrbit Health is not a medical practice. It does not practice medicine or pharmacy and does not dispense medication. It works for the Practice as a business associate under HIPAA.

2. What telehealth is

Telehealth means receiving health care from a licensed provider who is not in the same room as you. The Practice provides two kinds of telehealth.

Questionnaire review (asynchronous care). You answer an online health questionnaire, and a licensed provider reviews your answers later rather than live with you. This is the usual way care begins. Your provider may contact you with questions before deciding on treatment.

Video visit (synchronous care). You meet a licensed provider live by secure video, using a link in your patient portal. Video visits are not recorded. Please do not record your visit. A video visit is required when:

• the medication you asked for is a controlled substance;
• the medication or service you ordered requires a live visit, as shown when you order;
• the law in your state requires a live visit to begin care, or does not allow questionnaire-only care for that medication;
• you chose a video consultation; or
• your provider decides a live visit is needed for your care.

If a video visit is required, you will be told at checkout or afterward, and no prescription will be written until the visit takes place. Some states allow a recent in-person visit to meet this requirement. For medications that are not controlled substances, if your state allows it, your provider may offer a phone visit instead. Your provider will tell you if either applies.

3. Possible benefits

Telehealth may:

• let you receive care without traveling to an office;
• let you receive care at a time that suits you; and
• make it easier to follow up with your provider and ask questions.

4. Risks and limitations

Telehealth is not the same as an in-person visit. You should understand these risks and limits.

• No physical exam. Your provider cannot examine or test you in person. Your provider relies on what you report and on any records or lab results you share. Something important could be missed.
• Incomplete or inaccurate information. If the information you give is incomplete or wrong, your provider could make a decision that is not safe for you.
• Technology problems. Internet, video, or device problems may delay or interrupt your care, and a visit may need to be rescheduled.
• Security risks. We use safeguards to protect your information. No electronic system is perfectly secure, and there is a risk that your information could be intercepted or seen by someone who should not see it.
• Delays. A questionnaire is not reviewed live. There may be a wait before a provider reviews it or replies to you.
• In-person care may be needed. Your provider may decide that telehealth is not right for your condition and may advise you to see a provider in person, get lab work, or go to urgent care or an emergency room.

5. Telehealth is not for emergencies

Do not use this service for a medical emergency. If you think you have a medical emergency, call 911 or go to the nearest emergency room right away. If you are having a mental health crisis or thoughts of harming yourself, call or text 988 (the Suicide and Crisis Lifeline).

Portal messages are not monitored around the clock. Do not use them for urgent problems.

6. Alternatives

You do not have to use telehealth. Other choices include:

• seeing your own doctor or another provider in person;
• visiting an urgent care center or clinic; or
• choosing not to be treated.

You can discuss these choices with a provider.

7. No guarantee of a prescription or result

Submitting a questionnaire, paying at checkout, or having a visit does not guarantee that you will receive a prescription. A licensed provider will independently evaluate your information and decide whether treatment is appropriate. Your provider may:

• prescribe the treatment you asked for;
• recommend a different treatment;
• ask you for more information, records, or lab results;
• ask you to have a video visit or a follow-up visit; or
• decline to prescribe.

Your provider decides based on their professional medical judgment. Individual results vary, and no specific outcome is promised.

8. Medications your provider recommends

This consent covers receiving care by telehealth. It is not consent to any specific medication. Before or when your medication is sent, your provider or pharmacy will give you information about its benefits, risks, and side effects. You can ask your provider questions at any time and may stop treatment at any time.

9. Off-label and compounded medications; investigational drugs

Off-label use. A medication is used "off-label" when it is prescribed for a purpose, dose, or patient group that is not listed on its FDA-approved label. Off-label prescribing is legal and common when a provider believes it is medically appropriate, but the FDA has not reviewed the medication for that particular use, and there may be less information about its safety and effectiveness for that use.

Compounded medications. Your provider may prescribe a compounded medication. Compounded medications are prepared by a licensed pharmacy for an individual patient. They are not FDA-approved. This means the FDA has not reviewed them for safety, effectiveness, or quality before they are dispensed. They are not the same as FDA-approved brand or generic drugs and may differ in strength, ingredients, and how they work in your body. The pharmacy that prepares them operates under state and federal oversight. Your provider will decide whether a compounded medication or an FDA-approved product is right for you, and you can ask about the differences.

Investigational drugs. The medical practices in the MyOrbit Health provider network do not prescribe investigational drugs, which are products that have not completed FDA review.

Your agreement. Your health questionnaire may ask whether you agree to off-label or compounded use. If you agree, you agree only for the specific medication and use your provider prescribes for you after reviewing your information, not for any other medication. You may say no. If you do, your provider will not prescribe that medication for that use, and you can ask about alternatives, including FDA-approved options where they exist. You may also change your mind later by telling your provider.

10. Controlled substances

Some medications are controlled substances under federal and state law. For these medications:

• a controlled substance is prescribed only after a live video visit or an in-person visit with your provider, and never after a questionnaire alone or a phone-only visit;
• your identity will be verified, for example using the photo ID you provide;
• you will be asked to agree to a controlled-substance agreement, to allow a check of your state's prescription drug monitoring program, and to store the medication safely where others in your household cannot reach it;
• your provider checks your state's prescription drug monitoring program where required; and
• some states have additional rules, such as an in-person visit within a set period or limits on the amount prescribed, and your provider will follow them.

Federal and state rules on prescribing controlled substances by telehealth may change. If they do, you may need an in-person visit to continue treatment.

11. Prescriptions, pharmacies, and refills

If your provider prescribes a medication, a licensed pharmacy fills it and ships it to you. A pharmacy may be unable to ship to some states, which may delay or prevent filling a prescription.

If your prescription includes refills, refills are sent only while a valid prescription is active. Tell your provider about any change in your health, new medications, pregnancy, or new diagnoses before a refill. Your provider may ask for a check-in before a refill is sent.

12. Your responsibilities

By agreeing to this document, you agree to:

• Be truthful. Give accurate, complete, and honest answers about your health, medications, allergies, and history.
• Use your own identity. Use the service only for yourself. You confirm that you are the person receiving treatment. We may ask you to verify your identity and may stop care if we cannot.
• Give your real location. Tell us the state where you will be when you receive care, and tell us if you move or will be in another state.
• Keep your information current. Tell your provider about changes in your health, including before a refill.
• Follow your treatment plan. Take medication only as prescribed and do not share it with anyone.
• Follow up. Respond to your provider's messages, attend visits your provider asks for, and get any labs or in-person care your provider recommends.
• Report side effects. Tell your provider about side effects or problems through your patient portal. For serious symptoms, get emergency care right away.
• Keep your doctors informed. We encourage you to tell your regular doctor about the care you receive from us.

13. Adults only

This service is only for adults. You must be at least 18 years old, or at least 19 if you are in Nebraska when you receive care. We do not treat minors.

14. Provider licensing

Your provider will be licensed in the state where you are located when you receive care. Services may not be available in every state. If we cannot provide care in your state, you will receive a full refund for that order, as described in the Refund Policy.

15. Your records and privacy

The Practice keeps a medical record of your care, including your questionnaire answers, messages, visit notes, prescriptions, and any lab results or documents you share. Your provider may use software tools, including artificial intelligence, to help prepare visit notes. A licensed provider reviews and approves every note, and artificial intelligence does not decide whether you are prescribed a medication.

How your health information is used and shared, and your rights to access and amend it, are explained in the Notice of Privacy Practices at https://my.myorbithealth.com/legal/notice-of-privacy-practices.html. In summary:

• Your information is used for your treatment, payment, and health care operations. It is shared with those who need it to care for you and to operate the service, such as pharmacies, laboratories, payment processors, and technology vendors.
• The brand through which you ordered receives only the information needed to process, ship, and support your order and care, such as your contact and shipping details, the status of your order and care, the details of any prescription for your order, and, if a provider declines treatment, the reason. The Notice of Privacy Practices describes this in more detail. The brand does not use your health questionnaire answers for any purpose other than helping you obtain care from the Practice.
• The brand acts under a written agreement with the provider network and MyOrbit Health that limits its use of your information to helping with your order and care, and bars it from using your information for its own marketing or selling it.
• We do not sell your health information.

16. How we contact you

We contact you through your patient portal (or the brand's app, if you use one), by email, and by phone when your care requires it. Please check your portal for messages.

Emails concern your care, your order, and your account. We keep clinical details out of emails, but an email may show the brand or the type of treatment you ordered. Sign in to your portal to read full details. Ordinary email is not encrypted. You can opt out of non-essential emails, but messages needed for your care, your orders, and your account will still be sent.

We will not send you text messages unless you have agreed to receive them.

17. Payment and refunds

You are charged at checkout, before a provider reviews your information. The price shown at checkout covers the provider's review and any required visit. Because a prescription is not guaranteed, you could pay and not receive one. If a provider declines treatment, you will receive a full refund for that order, as described in the Refund Policy.

If you chose a plan, it renews automatically at the price and cadence shown at checkout until you cancel. You can cancel anytime in your patient portal or by emailing hello@myorbithealth.com. Cancelling stops future renewals.

Because of pharmacy laws, dispensed medication cannot be returned. If your order arrives damaged, wrong, or incomplete, or never arrives, contact us at hello@myorbithealth.com within 7 days of delivery (or of the expected delivery date).

Refunds, renewals, and cancellations are explained in full in the Refund Policy at https://my.myorbithealth.com/legal/refund-policy.html. If you paid the brand through which you ordered directly, that brand's refund policy may apply.

18. Your right to refuse or withdraw consent

You may refuse telehealth care, and you may withdraw this consent at any time, for any reason, by sending a message through your patient portal or emailing hello@myorbithealth.com.

If you withdraw consent:

• we will stop providing telehealth care to you;
• we will stop pending orders and refills that have not yet been sent to the pharmacy;
• if you have a plan, you will also need to cancel it to stop future charges, which you can do in your patient portal or by emailing hello@myorbithealth.com;
• it does not affect care already provided or actions already taken, such as a prescription already sent to a pharmacy or an order already shipped; and
• it does not affect your right to receive care in other ways.

19. Questions

For questions about your care, send a message through your patient portal. For other questions, email hello@myorbithealth.com or call (951) 329-2195.

For privacy questions or to exercise your privacy rights, contact the Privacy Officer, MyOrbit Health provider network, at hello@myorbithealth.com or (951) 329-2195, or write to Privacy Officer, MyOrbit Health provider network, c/o MyOrbit Health, Inc., 3524 Silverside Road, Suite 35B, Wilmington, DE 19810-4929.

20. Acknowledgement

By checking the consent box or otherwise indicating my agreement, I confirm that:

• I have read this Telehealth Informed Consent, or had it read to me, and I understand it.
• I understand I am receiving care via telehealth: a licensed provider will review my health information and may contact me before prescribing.
• I understand telehealth has limitations compared to in-person care, including the absence of a physical examination.
• I understand that completing a questionnaire or paying does not guarantee a prescription; that the provider may decline to prescribe, recommend an alternative, or request more information; and that results vary and no specific outcome is promised.
• I understand that a compounded medication, if prescribed, is not FDA-approved, and that off-label use is covered by section 9.
• I understand telehealth is not for emergencies, and if I have a medical emergency I will call 911.
• I confirm the information I provided is accurate and complete, and I am the adult receiving care.
• I know I can ask my provider questions at any time, may decline care, and may withdraw consent at any time.

By agreeing, you also acknowledge that you have received the Notice of Privacy Practices and the Refund Policy.

I have read and agree to the terms above, and I consent to receive care by telehealth.