Telemedicine Informed Consent

What is Telemedicine?

Telemedicine is the remote delivery of healthcare services by a Healthcare Service Provider (“HSP”) using information and communication technologies that involves sharing Your personal health data and medical information with the HSP via a text, audio or video-based medium, on the basis of which the HSP will arrive at a diagnosis and treatment plan (“Teleconsultation”).

Through the Portal (as defined in the Website Terms of Service) available on the website of Livlong Protection & Wellness Solutions Limited (“LPWSL”) You have requested to avail Teleconsultation services, and in pursuance of the request, Teleconsultation session(s) will be scheduled.

Your enjoyment of the Teleconsultation services, depends on the terms and conditions outlined in this Telemedicine Informed Consent Document.

Risks of Teleconsultation:

You understand that, in addition to the risks associated with treatment being administered through Teleconsultation, Teleconsultation itself bears certain risks. These include:

The inability to have direct, physical contact with the patient may impact the quality of service and treatment being rendered;

In rare cases, information transmitted may not be sufficient (e.g. poor resolution of images) to allow for appropriate medical decision making by the HSP(s);

Delays in medical evaluation and treatment could occur due to deficiencies or failures of the technical infrastructure;

In very rare instances, security protocols could fail, causing a breach of privacy of personal health data and medical information;

In rare cases, a lack of access to complete medical records or personal health information may result in judgment errors or recommendations that may cause adverse or allergic reactions.

Doctor-Patient Relationship:

You understand that this Teleconsultation is being facilitated by LPWSL, but will be provided by an HSP. LPWSL is not qualified to and does not provide medical advice or associated services. There is no doctor-patient relationship being established between LPWSL and Yourself.

Outcomes of Teleconsultation:

You understand that the outcome of the Teleconsultation is solely reliant on the personal health data, and medical information that You provide, and agree to provide only such information to the HSP that is true and accurate.

You understand that the diagnosis and treatment plan determined during the Teleconsultation could vary based on Your condition, and that You should reach out to a HSP for an in-person consultation if You experience an emergency or Your clinical condition worsens.

You understand that, by agreeing to a Teleconsultation, neither LWPSL nor the HSP guarantees its viability for Your particular case, and the HSP is at liberty to, at any time, discontinue the Teleconsultation at his/ her discretion.

You understand that if Your HSP believes You would be better served by another form of medical consultation (e.g. in-person consultation) You will be referred to a HSP associated with LWPSL who can provide such services in Your area.

Neither the HSP nor LPWSL make any explicit or implied guarantee that a prescription, or a medical certificate will be issued to You following the Teleconsultation.

Teleconsultation Patient’s Rights:

You understand that You are entitled to the following rights with respect to the Teleconsultation services and session(s):

You may withhold or withdraw consent at any time without affecting Your right to future care or treatment;

The laws that protect the confidentiality of Your medical information also apply to the Teleconsultation;

You will have access to Your medical records for the entire duration of availing the service of Teleconsultation, and are free to request copies thereof, or request transmission/ communication of these records to any third party of Your choice;

Details of Your Teleconsultation, and any medical information provided to HSP during Your Teleconsultation may not be transmitted/ communicated to any third party for processing, storage, or use without Your explicit consent;

Dissemination of any personally identifiable images or information relating to the Teleconsultation to researchers or other entities shall not be carried out without Your explicit consent.

Processing of Teleconsultation Data:

You understand that Your personal health data, medical information, and details of Your Teleconsultation sessions may be recorded and collected by LWPSL.

As such, You understand that the information disclosed by You during the course of Your Teleconsultation is generally confidential. However, there are both mandatory and permissive exceptions to such confidentiality under the law.

You also understand that personal data provided to LPWSL (including personal health data and medical information) is being collected, stored, used and processed in accordance with LPWSL’s Privacy Policy.

You understand that recordings of Your Teleconsultation, in whatever medium, will be retained by the HSP in accordance with the applicable Law; and the same may be shared in anonymized form with LPWSL for use, processing and storage for a minimum period of three (3) years, or till such time as necessary to offer continued services from the date of Teleconsultation.

Acceptance of Terms:

By signing below, You acknowledge and agree that the Teleconsultation services will be governed by the Terms of Service and Privacy Policy, as well as this Informed Consent Form.

Furthermore, You hereby acknowledge and agree to provide free, informed, and conditional consent to LPWSL for collecting and processing Your personal health data and medical information in accordance with its Privacy Policy.

You hereby declare that You are above eighteen (18) years of age, and competent to contract. If You are agreeing to these terms for the treatment of a third-party patient, then You declare that You are sufficiently authorized to provide consent to treatment on behalf of the patient.

You hereby agree to avail Teleconsultation services offered by LPWSL for Your medical care.

BY ENGAGING THE TELEMEDICINE SERVICES, YOU AGREE AND CERTIFY THAT YOU HAVE READ AND UNDERSTAND THE INFORMATION PROVIDED ABOVE, AND UNDERSTAND THE RISKS AND BENEFITS OF TELEMEDICINE. BY ACCEPTING THESE TERMS, YOU HEREBY GIVE YOUR INFORMED CONSENT TO PARTICIPATE IN A TELEMEDICINE SESSION AND FOR THE USE OF TELEMEDICINE IN YOUR MEDICAL CARE.