Legal

Informed Consent for Telehealth Services

Last updated: January 1, 2026

What Is Telehealth

Telehealth involves the delivery of health care services using interactive audio, video, and/or electronic communications. Meridian Health provides telehealth services through asynchronous (store-and-forward) and, where available, synchronous (real-time video) consultations between patients and independent licensed providers.

Benefits of Telehealth

  • Access to licensed providers without travel
  • Faster review of your health history and assessment
  • Coordination with pharmacy partners for medication delivery
  • Ongoing care management through the member portal

Limitations and Risks

Telehealth has specific limitations compared to in-person care. By using Meridian's services, you acknowledge and accept the following:

  • Physical examination: The reviewing provider cannot perform a physical examination. Clinical decisions are based on the information you provide in your intake. Providing inaccurate or incomplete information may affect the safety and appropriateness of any treatment recommendation.
  • Asynchronous review: Your intake is reviewed asynchronously. You are not communicating with a provider in real time during the assessment process.
  • Emergencies: Telehealth is not appropriate for medical emergencies. If you are experiencing a medical emergency, call 911 or go to your nearest emergency room immediately.
  • Technology failures: Delays or service interruptions may occur due to technical issues beyond Meridian's control.
  • Prescribing limitations: Providers may decline to prescribe if they determine telehealth is insufficient to make a safe clinical judgment. Eligibility is not guaranteed.
  • State availability: Telehealth services are available only in states where Meridian providers are licensed. Availability may change.

Your Rights

  • You have the right to withhold or withdraw consent to telehealth services at any time without affecting your right to future care or treatment.
  • You have the right to review the credentials of the licensed provider who reviews your intake.
  • You have the right to request that any telehealth encounter be documented and that records be sent to another provider.
  • You have the right to opt for in-person care with a provider in your area rather than using telehealth services.
  • You have the right to ask questions about the telehealth process at any time.

Provider Independence

Providers who review intakes through the Meridian platform are independent licensed professionals. Meridian does not direct, control, or influence their clinical decisions. The provider who reviews your intake makes an independent judgment about whether to prescribe, and what to prescribe, based on the information available.

Privacy and Security

All information transmitted through the Meridian platform is encrypted. We maintain HIPAA-compliant security practices. Details are in our HIPAA Notice of Privacy Practices and Privacy Policy.

Medications and GLP-1 Safety

If a GLP-1 receptor agonist is prescribed through the Meridian platform, you acknowledge that:

  • GLP-1 medications are not appropriate for everyone and carry risks including pancreatitis, gallbladder disease, and thyroid tumors in patients with specific risk factors.
  • You have disclosed all relevant health history, current medications, allergies, and contraindications in your intake.
  • You will read the full prescribing information provided with any medication.
  • You will contact the Meridian care team or seek in-person care immediately if you experience concerning symptoms.
  • You understand that individual results vary and that weight loss is not guaranteed.

Consent

By completing the Meridian eligibility assessment and creating an account, you acknowledge that you have read, understand, and agree to this Informed Consent for Telehealth Services. You understand:

  • The nature of telehealth services and their limitations
  • The risks associated with telehealth versus in-person care
  • Your right to withdraw consent at any time
  • That providers are independent and make independent clinical decisions

If you do not agree, do not complete the assessment or create an account. You may seek care from an in-person provider in your area.

Contact

Questions about this consent: care@northmarkhealth.com

Legal review required. Telehealth informed consent requirements vary by state. Many states require specific disclosures, provider identification, and patient acknowledgment of limitations. This template must be reviewed and approved by qualified legal counsel before publication. State-specific addenda may be required for certain jurisdictions.

Important Safety Information (ISI) — GLP-1 Receptor Agonists

GLP-1 receptor agonists (semaglutide, tirzepatide, liraglutide) are FDA-approved prescription medications. They are not appropriate for everyone. Do not use if you or a family member have a history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2).

Serious risks include: pancreatitis, gallbladder problems, kidney problems, hypoglycemia (in patients using insulin or insulin secretagogues), heart rate increase, suicidal ideation and behavior, and serious allergic reactions. Tell your provider about all medications you take and all medical conditions.

The most common side effects are nausea, diarrhea, vomiting, constipation, and stomach pain. These are usually mild and decrease over time.

Not for use in patients with type 1 diabetes. If you experience severe abdominal pain, stop the medication and seek immediate medical attention. For full prescribing information, consult your Meridian Health provider.