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Telehealth Informed Consent

Your consent to receive care through telehealth technology.

Effective date: September 19, 2026

Platform: Everlon Health LLC ("Everlon," the "Platform") Care provided by: independent, licensed providers practicing through an independent professional medical group. Your provider's name is shown to you during your care, and their credentials, license type and state of licensure are available to you on request.

By checking "I agree" (or signing), you acknowledge the terms below and authorize Everlon Health LLC to process and transmit your health information to the provider network and its partners so that care can be delivered to you.

1. The nature of telehealth

Telehealth means the use of secure electronic communications — including online questionnaires, secure messaging, and/or live video — to deliver health care without an in-person visit. Care may be:

  • Synchronous (a real-time video visit with your provider), or
  • Asynchronous ("store-and-forward" — you submit information and a licensed provider reviews it and responds, without a live visit).

How care works on Everlon:

  • Most services use asynchronous review: you complete a health questionnaire, and a licensed provider reviews your information and, only if clinically appropriate, issues a treatment plan — without a live visit.
  • Everlon does not currently offer any controlled-substance service. If one is ever offered, it will require a scheduled, real-time video visit (two-way live video and audio) with a licensed provider before any prescription may be issued, along with baseline and ongoing lab work as directed by your provider.
  • Your provider may require a synchronous visit, additional information, or lab work for any service when clinically indicated.
  • You can ask questions. Before agreeing to treatment and at any point during care, you may send questions using the contact methods provided — including care@everlon.health and the contact options shown in your account. We do not commit to a response time. You may ask whether a video visit is available for your care; availability depends on the service, your state, and your provider's clinical judgment.

2. Who provides your care

Your care is provided by independent, licensed providers. Everlon is a technology platform; Everlon does not practice medicine or pharmacy and does not control clinical decisions. Your provider exercises independent professional judgment and may decline to prescribe if treatment is not clinically appropriate.

3. Benefits of telehealth

Convenient access to licensed providers, greater privacy, and reduced travel and wait times.

4. Risks and limitations

You understand that:

  • A remote provider cannot physically examine you, and some conditions cannot be properly diagnosed or treated by telehealth.
  • The provider may determine that in-person care, lab work, or more information is needed, and may decline treatment on that basis.
  • Technology may fail or cause delays; rarely, security breaches can occur despite safeguards.
  • Information you provide that is inaccurate or incomplete can lead to inappropriate treatment.
  • As with any treatment, prescribed medications carry potential risks and side effects.

5. Prescriptions, controlled substances & compounded medications

5.1 General

Any prescription is issued solely at the discretion of your licensed provider, only when clinically appropriate, and is dispensed by a licensed U.S. pharmacy. No prescription is guaranteed, and no specific treatment outcome is promised or guaranteed. Your provider may decline to prescribe, may prescribe something different from what you requested, or may discontinue treatment at any time based on clinical judgment.

5.2 Compounded medications — general acknowledgment

Some medications available through the Services are compounded — prepared by a state-licensed U.S. 503A compounding pharmacy to meet an individual patient's needs. If your provider prescribes a compounded medication, you understand and acknowledge that:

  • Compounded drugs are not FDA-approved. The FDA does not review compounded drugs for safety, effectiveness, or quality before they are dispensed.
  • A compounded medication is not the same as — and is not a generic version of — any FDA-approved product, even when it contains the same or a similar active ingredient.
  • Safety and efficacy data for compounded medications may be limited or may vary compared with FDA-approved products, and compounded products may differ in dose, sterility, potency, or inactive ingredients.
  • Compounded medications carry known and unknown risks, including risks that may not yet be identified in the medical literature.
  • Certain uses of medication your provider prescribes may be "off-label" (a use not approved by the FDA). Your provider will exercise clinical judgment in any off-label prescribing decision.
  • FDA-approved alternatives, where they exist, are an option you may pursue — including outside the Platform. Ask your provider about alternatives.
  • Compounded medications are prescribed for your individual use only, pursuant to a valid prescription and a provider relationship. They are prescription medications — not "research chemicals" — and must never be shared with or resold to others.

Your provider will determine whether a compounded or a commercially available (FDA-approved) medication is clinically appropriate for you. No particular medication or outcome is guaranteed.

5.3 Your monitoring & reporting responsibilities

You agree that you will:

  • Promptly report side effects, adverse reactions, or unexpected symptoms to your provider through the patient portal or care@everlon.health.
  • Seek emergency care (call 911) for any severe reaction — e.g., trouble breathing, swelling of the face or throat, chest pain, severe abdominal pain, or an allergic reaction — and inform your provider afterward.
  • Complete all lab work and follow-up your provider orders.
  • Keep your health information current — new medications, new diagnoses, and pregnancy or plans to become pregnant can change whether treatment remains safe for you.
  • Tell your provider about your other health care providers and about any care you receive elsewhere. Because we may not have your complete medical records, incomplete information can lead to drug interactions, allergic reactions, or other errors in judgment — this is one of the real limitations of remote care.
  • You may also report side effects of any medication directly to the FDA's MedWatch program (fda.gov/medwatch or 1-800-FDA-1088).

Failure to provide accurate information or to follow monitoring instructions may increase your risk of harm and may result in your provider pausing or declining to continue treatment.

Treatment-specific riders

The rider(s) for the specific service(s) you request will be presented during intake and require separate acknowledgment. Each is part of this Consent.


The treatment riders (5A GLP-1 · 5C peptides & wellness) are NOT reproduced here. Each is a separately versioned document, presented and acknowledged on its own during intake.

6. Alternatives

You may choose to seek in-person care instead of telehealth at any time. Where FDA-approved alternatives to a compounded medication exist, you may ask your provider about them or pursue them through other channels.

7. Privacy and medical records

Your telehealth interactions and records are protected under HIPAA and applicable state law, as described in the applicable Notice of Privacy Practices and the Privacy Policy. A record of your care will be maintained in the Platform's secure health-record system.

You may inspect your records. You have the right to inspect the information obtained and documented during your telehealth care, and to receive copies — for which a reasonable, cost-based fee may apply, as described in the Notice of Privacy Practices.

No information identifying you that is obtained through telehealth will be disclosed to researchers or other outside entities without your consent, except as required by law.

8. Eligibility and your responsibilities

You confirm that you are 18 or older, are the person receiving care, are physically located in a state where the Services are offered, and will provide accurate and complete information.

9. Emergencies

Telehealth is NOT for emergencies. If you have a medical emergency, call 911 or go to the nearest emergency room.

10. Consent to electronic communications

You consent to receive care and communications electronically and understand you may request alternative means of communication.

11. Hold harmless for technology failure

You acknowledge that information may be lost or delayed due to technical failures beyond reasonable control.

12. Voluntary consent and right to withdraw

Your consent is voluntary. You may withdraw it at any time (except as to care already provided) by contacting care@everlon.health.

13. Cash-pay services & financial responsibility

You understand and acknowledge that:

  • Everlon is a cash-pay service. Services and medications are not billed to insurance, and Everlon and the independent providers do not accept insurance, Medicare, Medicaid, TRICARE, VA benefits, or any other government or commercial health plan.
  • You are responsible for all costs of the Services, which are disclosed to you before you pay. No claims will be submitted to insurance on your behalf. An itemized receipt is available on request.
  • You may be able to seek reimbursement from an HSA/FSA where eligible, but Everlon makes no promise of reimbursement.
  • Promotional pricing and discounts are not available to individuals enrolled in Medicare, Medicaid, or other federal healthcare programs.
  • Everlon does not order or bill for lab work and does not charge you for it. If your provider decides lab testing is needed, they will tell you directly and arrange it with you.
  • Refunds and cancellations are governed by the Terms of Service and the Shipping & Refund Policy.

14. Shipping authorization

If a provider prescribes medication for you, you authorize the dispensing pharmacy to ship it to the address you provide during intake, or to another address you later give us. You agree to:

  • Provide a complete, accurate address where you can receive deliveries, and update it before your next shipment if it changes;
  • Retrieve temperature-sensitive shipments promptly on the delivery day and store them as directed; and
  • Understand that some medications may require an adult signature at delivery and cannot be left unattended.

Prescription medications are dispensed according to state and federal law with the approval of the pharmacist in charge. Shipping timing, delivery problems, risk of loss, and replacement are governed by the Shipping & Refunds Policy.


Acknowledgment. By checking "I agree" (or signing), I confirm that:

  • I have carefully read and understand this Telehealth Informed Consent, including every treatment-specific rider presented to me;
  • I have had a meaningful opportunity to review this information and to ask questions through the Platform (using the contact methods provided) before agreeing;
  • I understand I can send questions at any time using the contact methods provided, and may ask whether a video visit is available for my care, subject to the service, my state, and my provider's clinical judgment; and
  • I voluntarily consent to receive telehealth services under the terms described above.

☐ I agree

(In the digital intake, this acknowledgment is captured as a required checkbox; the name and date are recorded automatically with your account and timestamp.)


Questions? Contact us at care@everlon.health.