Telehealth & Electronic Communication Policy

Telehealth is the delivery of healthcare using digital communication technologies rather than an in-person visit. Depending on your care, this may include:

• Live video conferencing with your provider
• Secure messaging through the patient portal
• Electronic transmission of medical information, images, and laboratory results
• Remote review of patient-reported measurements and history

Your provider determines whether telehealth is clinically appropriate for your situation, and may require an in-person evaluation before initiating or continuing treatment.

Choosing telehealth is voluntary. You have the right to seek care in person instead, and declining telehealth will not affect your ability to seek care elsewhere or to return to the Practice in the future.

If your provider determines that your condition requires in-person evaluation, physical examination, imaging, or testing that cannot be performed remotely, we will tell you and will help you identify appropriate local resources.

The Practice does not provide in-person care directly. Care that must be delivered in person will require referral to a local provider or facility.

Care is provided only to patients who are physically located, at the time of the visit, in a state where the treating provider holds an active, unrestricted license:

• California — Shape Theory Nursing, P.C., dba The Shape Theory
• New York — Shape Nurse Practitioner in Family Health, PLLC, dba The Shape Theory NY

You are responsible for truthfully disclosing your physical location at the start of each appointment. If you are located outside California or New York at the time of a scheduled visit, your provider cannot treat you and the visit will need to be rescheduled.

Your provider’s name, credentials, and license information are provided to you at the start of care and are available on request at any time.

California law requires that your consent to receive services by telehealth be obtained and documented in your medical record before services are provided. New York similarly requires that patients be informed about telehealth before care begins.

Your consent is documented through the Telehealth Informed Consent form you complete at intake, not through your use of this website.

You may withdraw your consent to telehealth at any time, for any reason, without affecting your right to future care or your ability to receive services in person elsewhere. Because our services are delivered exclusively by telehealth, withdrawing consent may mean the Practice can no longer treat you.

Telehealth has inherent limitations. Risks include:

• Inability to perform a complete hands-on physical examination
• Reliance on information, measurements, and history that you report
• Technical failures, delays, or interruptions that may prevent or degrade a visit
• Poor image or audio quality affecting clinical assessment
• Information security risks, including unauthorized access despite reasonable safeguards
• Delayed diagnosis or treatment where in-person evaluation would have been more effective

In rare cases, the inability to examine you directly or to access your complete records could contribute to an incorrect assessment or a delay in care. Telehealth is not appropriate for all conditions.

Prescriptions are issued only when clinically appropriate following an individualized evaluation. Scheduling or completing a telehealth visit does not guarantee that any medication will be prescribed.

Federal and state law restrict which medications may be prescribed through telehealth. The Practice does not prescribe controlled substances through telehealth.

Your provider may require laboratory work, vital signs, or an in-person evaluation before prescribing or continuing a medication, and may decline to prescribe where telehealth evaluation is insufficient.

The Practice may communicate with you using:

• Secure patient portal messaging
• Email
• Text (SMS) messaging
• Automated appointment reminders
• Telephone

Electronic communication is used for convenience, scheduling, and care coordination. It is not a substitute for a scheduled visit and is not monitored continuously. Messages are reviewed during regular business hours.

Standard SMS text messaging and unencrypted email are not secure channels. While we use reasonable safeguards, complete confidentiality cannot be guaranteed when communicating by:

• Standard text message
• Standard, unencrypted email

Messages may be intercepted, misdirected, or viewed by anyone with access to your device or accounts. Once a message is sent, we cannot recall it or control what happens to it on your end.

For anything sensitive, use the secure patient portal. You may ask us to limit or stop using text message or email at any time, and we will honor that request.

By providing your mobile phone number, you consent to receive text messages from the Practice related to your care, including:

• Appointment reminders and scheduling
• Follow-up and treatment-related instructions
• Administrative and billing notifications

Consent to receive text messages is not a condition of receiving treatment. Message frequency varies. Message and data rates may apply depending on your carrier.

Reply STOP to any message to opt out, or HELP for assistance. Opting out will not affect your care, though it may remove conveniences such as automated reminders.

Telehealth visits and your medical information are protected by the same confidentiality laws that apply to in-person care, including HIPAA, the California Confidentiality of Medical Information Act, and applicable New York law.

Information disclosed during a telehealth visit may be shared with other individuals involved in your care, consistent with those laws and with your authorization where required.

Our full privacy practices are described in our Notice of Privacy Practices.

The Practice does not record telehealth visits unless you are informed in advance and consent.

You may not record any portion of a visit — audio, video, or screenshot — without the prior consent of your provider. California law requires the consent of all parties to record a confidential communication.

Your provider will tell you if anyone else is present on our end of the visit. Please tell your provider if anyone else is present with you, and let us know if you would prefer to speak privately.

To receive telehealth services you will need a device with a working camera and microphone, a reliable internet or cellular connection, and access to the email address and phone number on file.

You are responsible for:

• Being in a private, well-lit location where you can speak freely
• Verifying your identity at the start of each visit
• Providing accurate and complete health information, including all medications and supplements
• Disclosing your physical location at each visit
• Not driving or operating a vehicle during a visit
• Reporting side effects or adverse reactions promptly
• Securing your own devices, email, and portal accounts

Telehealth visits are documented in your medical record in the same manner as in-person visits. You have the right to request access to and copies of your records, subject to applicable law.

Fees for telehealth services, medications, and related products are disclosed before you are charged. Many of our services are self-pay and may not be covered by insurance. You are responsible for verifying coverage with your insurer if you intend to seek reimbursement.

Missed appointments and late cancellations may be subject to a fee, as described in your service agreement.

Telehealth care through the Practice is not a substitute for a primary care provider. We encourage you to maintain a relationship with a local primary care provider and to authorize us to share relevant information with them.

If your care requires services we cannot provide remotely, your provider will discuss referral options with you.

If you need interpretation services or an accommodation in order to participate in a telehealth visit, contact us before your appointment and we will make reasonable arrangements.

If you have a concern about your care or about this policy, please contact us first — most issues are resolved directly.

You may also contact the licensing board for the state in which you received care:

• California — Board of Registered Nursing, California Department of Consumer Affairs
• New York — Office of the Professions, New York State Education Department

Current contact information for each board is available on the respective state agency website.

We may update this policy at any time. Changes take effect when posted, and the effective date shown above will be revised accordingly. Material changes affecting your care will be communicated to you directly.

For questions about this policy or our telehealth services, please contact: