Asynchronous Telemedicine Consent
Last Updated: May 10, 2024
Make sure you read all the important information below because we cover:
- When our duty of care begins.
- The benefits and risks of using our service.
- The importance of reading all the information we provide.
- The importance of answering all questions fully and truthfully.
- The risks of accepting our treatment plan.
- The risks to electronic health information.
Only use our service if you’ve read this information and subsequently made an informed decision that our service is right for you.
If you have any questions, please email us at [email protected] or call us at (650) 437-1213.
Notice for patients in California – this service is provided by Pandia Medical Group on the Pandia Health platform (together referred to as ‘Pandia’).
Notice for patients in Texas – this service is provided by Ideal Medicine PLLC and Catherine Hansen MD Professional Association (together referred to as ‘Pandia’).
NOT FOR EMERGENCIES
I understand that I should never use Pandia in a medical or psychiatric emergency. I understand that in an emergency, I should dial 911 or go to an emergency department.
WHEN OUR DUTY OF CARE BEGINS
I understand that Pandia doctors (‘the Doctor’) will take responsibility for my care only after I have created an account, answered all the required health questions, and made payment, and the Doctor has subsequently reviewed my request for treatment and the health questions that I have completed, reviewed all my information, and then subsequently determined that I am a good candidate for the telehealth services. I understand that the duty of care does not begin at the point of me answering questions or making payment but at the point at which the Doctor accepts the duty of care.
I understand that the Doctor has the right to refuse to take responsibility for my care if the doctor makes a professional judgment that I am not a good candidate for this service. I understand that making a request for treatment (by completing a visit in the Pandia Health Website (the “Website”) and making payment) or sending a message through the website/app does not in and of itself create a duty of care nor create a doctor-patient relationship.
I understand that there may be a delay 1-2 business days before a doctor reviews my request for treatment and any messages I send.
I understand that the only content in the Website that constitutes professional medical advice is the personalized messages the Doctor sends me (once I have completed the health questions and made payment, and the Doctor has subsequently taken responsibility for my care) and any content that the Doctor links to in such messages. No other content in the Website constitutes professional medical advice. Specifically, the information provided in our health questions about who we can and cannot treat does not constitute professional medical advice.
I understand that all other content on the Website does not constitute professional medical advice and is instead for information purposes only. Never disregard professional medical advice or delay in seeking it because of something you have read on our Website.
BENEFITS AND RISKS OF USING OUR SERVICE
I understand that by using the service I’m seeking quality care that’s convenient and affordable.
I understand that important differences exist between Pandia’s model of care and traditional healthcare. Specifically by using Pandia, I accept a far greater responsibility to read and understand information throughout the Website about the limitations of Pandia’s model of care, the risks of seeking care this way, and the risks and benefits of a proposed treatment plan.
I understand that I must read and understand the Consent to Telehealth, the Terms of Use, the Privacy Policy, the information provided about a service before I answer health questions, the information provided in the health questions themselves, messages I receive from Pandia, and, very importantly, content provided via links in the message that the Doctor sends me after the Doctor has reviewed all my information and recommended a treatment plan and, when appropriate, prescribed a medicine.
I understand that to read important information I may need to both click on links and various titles to expand the information that’s visible below, and that without clicking on links and titles I will not be able to read important information that enables me to give my informed consent to a treatment.
I understand that by using Pandia I accept the responsibility to provide full and truthful answers to all questions and, when requested, to provide unaltered photos of me that are taken at the time of using our service.
I understand that the Doctor is unable independently to verify the information and photos I provide and that the Doctor will make a professional judgment based on the information and photos I provide.
I understand that I won’t receive any other medical services that go beyond the diagnosis and prescription for birth control, acne, and/or menopause. I need to seek other sources of care for my other medical needs.
I understand that by using the service for a telemedical consultation, I will NOT have an in person consultation nor a physical exam that might identify a medical condition that needs further investigation or immediate treatment.
I understand that by using the service I won’t speak or message with a doctor or nurse in real time.
I understand that I must check the Website for messages because this is the way that the Doctor will communicate important information to me. I understand that if I don’t check the Website regularly, then my care may be delayed.
I understand that if I have any questions relating to my care that are not urgent, I can message the Doctor through the Website. I understand that a doctor may not review and respond to my messages until the next business day.
IMPORTANCE OF READING ALL THE INFORMATION WE PROVIDE
I understand that Pandia will provide detailed information on the Website to help me make an informed decision about whether to accept a proposed treatment plan. The most important information about a treatment plan is in the link that the doctor will send me when the doctor prescribes a treatment. This information includes detailed information to help me decide if the benefits of the treatment plan outweigh the risks, given the alternative options available to me, which includes the option of not taking any treatment.
I understand the importance of reading the information the doctor provides about adverse events, including the signs and symptoms of serious side effects and common side effects from taking a medicine, as this will ensure that I seek appropriate medical attention in a timely manner.
IMPORTANCE OF ANSWERING ALL QUESTIONS FULLY AND TRUTHFULLY
I understand that by using Pandia I seek to enter into a relationship where the Doctor relies exclusively upon information and photos that I provide to decide whether or not treatment is safe and appropriate.
I understand that the Doctor has no way of verifying the information and photos that I provide and that the doctor will consider information to be accurate, true and complete, including my age, gender and all my answers to health questions, and the photos to be of me, taken at the time of me using the service, and unaltered.
I understand that if I provide information that is not true or incomplete, then I’ll be at greater risk of adverse events from any treatment that the doctor prescribes and I may receive a treatment that is unnecessary, inappropriate, or unsafe.
I understand that if I provide photos that are altered, not of me or not taken at the time of me using the service, then I’ll be at greater risk of adverse events from any treatment that the Doctor prescribes and I may take a treatment that is unnecessary, inappropriate, or unsafe.
I understand that even if I provide information that is true and complete, I’m still at risk of adverse events from any treatment that the Doctor prescribes.
I understand that even if I provide photos that are unaltered, of me and taken at the time of using the service, I’m still at risk of adverse events from my treatment that the Doctor prescribes.
I understand that it is important that I do not create more than one account. Creating more than one account makes it impossible for the Doctor to see the full history of care that I have received from Pandia. This increases the chances that the Doctor will not have access to important information and photos in my medical record that could influence the Doctor’s clinical decision.
RISKS OF ACCEPTING OUR TREATMENT PLAN
I understand that all the medicines that the Doctor may prescribe can cause serious side effects and adverse events that include severe allergic reaction, permanent disability, and death.
I understand that it is my responsibility to make an informed decision whether to accept a treatment plan that the doctor proposes after weighing the risks and benefits of the medicine being prescribed, alternative treatment options and the risks and benefits of such alternatives, and the option of not seeking any treatment.
I understand the importance of reading the manufacturer’s leaflet that comes with a medicine before I take a medicine because this leaflet includes important information about risks and warnings.
I understand that adverse events can be caused by a number of things, including an allergic reaction, side effects, undiagnosed blood disorder/medical condition, or interactions between a medicine that the doctor prescribes and any medical conditions I may have, other prescription medicines or other things (e.g., supplements, herbs, over-the-counter medicines, or recreational drugs) I’m taking, and lifestyle choices such as smoking tobacco products or drinking alcohol.
For ACNE patients
I understand that adverse events from taking antibiotics to treat acne include but aren’t limited to allergic reaction, infectious diarrhea, permanent disability, and death.
I understand that by using Pandia to diagnose and treat acne, there’s a risk that the doctor misdiagnoses the cause of my skin problem resulting in a delay in diagnosing the true cause of my problem and that I’ll take medicines unnecessarily and expose myself to the risks of taking those medicines.
I understand that by using Pandia to diagnose and treat acne, the doctor is unable to do a complete and thorough skin exam of my whole body because of the limitations of telemedicine and that an in person doctor visit would conduct a more thorough skin exam. Because Pandia’s doctors cannot do a thorough skin exam, there is a risk that they may not identify a medical condition that needs further investigation or immediate treatment. There is also a risk that the photos of my skin that I send to Pandia are not representative of my condition and that based on the photos I send, Pandia’s doctor may misdiagnose my condition.
I understand that even if Pandia’s doctor correctly diagnoses me with acne and initially prescribes treatment, it may subsequently be necessary for me to seek additional care with a doctor in person if the treatment is not effective or the doctor considers my acne to be too complicated to manage online.
For BIRTH CONTROL PILLS / PATCHES / RINGS/ Injection Patients
I understand that adverse events from using birth control pills / patches / rings include but are not limited to stroke, heart attack, and death.
I understand that I can request a prescription for many different types of birth control and that different types have different risks of adverse events and different side effects.
I understand that in general, combination birth control pills/patches/vaginal rings have a higher risk of serious side effects and adverse events, including blood clots, stroke, permanent disability, and death, than progestin-only pills. Combination pills/ patches/ vaginal rings contain 2 hormones, estrogen and progestin.
I understand that if I request a prescription for a combination pill/patch/vaginal ring then it is important that I provide a recent and accurate blood pressure measurement because it is not appropriate to take combination pills if I have a history of elevated blood pressure or currently have high blood pressure.
I understand that if I take a combination pill/patch/vaginal ring without knowing my blood pressure then I have a significant risk of blood clots, stroke, permanent disability and death.
I understand that if I request a prescription for a specific birth control pill/patch/vaginal ring, then I accept any increased risk of adverse events and serious side effects associated with that particular medicine. Also, if I choose an option not covered by my insurance such as insisting on a name-brand when the insurance only covers generic, then there will be added costs which I must pay or I will not receive the medication.
For MENOPAUSE PATIENTS
I understand that if I take systemic hormonal treatment without having had a mammogram according to current guidelines, then I have an increased risk of breast cancer.
RISKS TO ELECTRONIC HEALTH INFORMATION AND DATA SECURITY
We have implemented a wide range of administrative, physical, and technical safeguards to reasonably secure your Personal Health Information (PHI) from accidental loss and from unauthorized access, use, alteration, and disclosure and to comply with HIPAA.
You have chosen a password which enables you to access certain parts of our Platform and you are responsible for keeping this password confidential. Do not share your password with anyone. The information you share in public areas (such as comments on blogs, videos, etc.) may be viewed by any user of the Platform.
When you use our Platform there is a risk that your PHI will be stored unencrypted on your mobile device. Unfortunately, the transmission of information via the Internet is not completely secure. Although we will do our best to protect your Personal Health Information, we cannot guarantee the security of your data transmitted to our Platform; any transmission is at your own risk. We use a variety of technical safeguards to maintain the security of your information and to prevent unauthorized access to it by those who do not have a legitimate need for it. In addition, we make sure to comply with HIPAA law and we periodically review our security measures. We will never post your e-mail address or other identifying information you have provided on our App without your consent. Please note that no method of transmission over the Internet or method of electronic storage is 100% secure.
For more details about how Pandia protects and uses your health information and complies with HIPAA, see our Privacy Policy.
Menopause Membership T&C’s
Pandia Health’s Menopause Membership services include asynchronous online doctor consultations, communication services, and other technology-enabled or personal support. Members on quarterly or annual plans also receive complimentary access to the “Meaningful Menopause” workshop video series as part of their membership benefits.
How to Pause Shipments
To pause your membership-only plan, please contact our support team at [email protected] and let us know until which date to pause your membership. While your membership will remain active during the pause period, medication refills will not be sent.
How to Cancel Your Membership
You may cancel your account anytime by emailing [email protected]. However, your account will remain active until the cancellation process is complete and you receive confirmation.
Once your account is deactivated, we will still keep your medical records on file as mandated by Federal law (generally 10 yrs). This ensures we are able to provide your medical information to future providers if needed. The security of patient data is of utmost importance to Pandia and your information is stored in encrypted form on our servers according to strict federal standards, including HIPAA.
Pandia Health will not provide any refunds for new sign ups or annual renewals unless you cancel before the doctor reviews your health information. For automated renewals, Pandia Health can provide a refund if you cancel within 7 days of payment. Rebates will be calculated based on months remaining in the membership starting with the next full month. Any remaining credits will be refunded within 7-10 business days.