Informed Consent For Telehealth Services

Revised October 22, 2026

This consent explains how Alpha Hormones Inc. (“Alpha Hormones,” “we,” or “us”) provides care through telehealth and asks for your informed consent to receive it. You accept this consent when you sign it, click “I agree,” check an acceptance box, or give verbal consent that we document in your medical record. If someone accepts on your behalf, you authorize that person to act as your agent for this purpose.

1. What Telehealth Is

Telehealth is healthcare delivered through electronic communication, such as live video, phone calls, secure messaging, and the exchange of medical records, images, lab results, and device data. Alpha Hormones physicians, physician assistants, and nurse practitioners (“Providers”) may use telehealth for evaluation, diagnosis, treatment, follow-up, and education.

Alpha Hormones also offers in-person care at our Pasadena office. Telehealth is an option, not a requirement.

2. Who Can Use Telehealth

  • You must be physically located in a state where your Provider is licensed at the time of each telehealth visit. Alpha Hormones currently provides telehealth to patients located in California, Florida, and Texas.
  • We may verify your identity and your location at each visit.
  • Some services, examinations, and prescriptions require an in-person visit under federal or state law or in your Provider’s clinical judgment.

3. Possible Benefits

  • Easier and more convenient access to care.
  • Fewer trips to the office and less time away from work or home.
  • Timely follow-up, lab review, and treatment adjustments.

4. Possible Risks and Limitations

  • Physical examination limits: Your Provider cannot perform a hands-on exam or certain tests during a telehealth visit, which may limit diagnosis or treatment or delay recognition of a problem.
  • Technology problems: Poor connections, equipment failure, or software errors may interrupt or delay your visit or affect the information your Provider receives.
  • Privacy and security: Despite reasonable safeguards, electronic communications carry a small risk of unauthorized access to your information.
  • Incomplete information: Care may be affected if your medical history, medications, or records are incomplete.
  • Need for other care: Your Provider may decide telehealth is not appropriate for your condition and ask you to come in person or seek care elsewhere.

Telehealth does not guarantee any specific result, and your condition may not improve.

5. Emergencies and Urgent Needs

Telehealth is not for emergencies. If you have a medical emergency, call 911 or go to the nearest emergency department. For nonurgent questions, message your care team through the patient portal or our secure messaging. If you cannot reach us that way, call (213) 334-4111 during business hours. If a telehealth visit is interrupted, your Provider will try to reconnect by video or phone.

6. Your Privacy

  • We use secure, HIPAA-compliant systems and protect your information as described in our Privacy Policy and Notice of Privacy Practices.
  • We do not record telehealth visits without your permission.
  • Please join visits from a private location. You will be told if anyone other than your Provider is present, such as a medical assistant, and you may ask that nonmedical personnel leave.
  • Your information may be shared for treatment, payment, and healthcare operations, or as otherwise permitted or required by law.

7. Prescriptions, Pharmacies, and Labs

  • Prescriptions, including controlled substances such as testosterone, are issued only when clinically appropriate and as permitted by federal and state law. Some may require an in-person evaluation.
  • Medications may be sent to a licensed compounding pharmacy that ships to you or to your local pharmacy. You may ask to use a different pharmacy.
  • Lab testing may be completed at our office, through Quest Diagnostics, or at another laboratory you choose, if your Provider can obtain the results.

8. Costs and Insurance

Telehealth visits are billed according to your selected program, self-pay visit fees, or your insurance coverage, as applicable. You are responsible for any copays, coinsurance, deductibles, and services your insurance does not cover. See our Subscription and Cancellation Policy and pricing for details.

9. Your Rights

  • You may ask questions about telehealth, including its benefits, risks, and alternatives, at any time.
  • You may decline or stop telehealth at any time and request an in-person visit at our Pasadena office, without affecting your right to future care.
  • You may withdraw this consent by notifying us in writing. Withdrawal does not affect care provided before we receive your notice.
  • You agree to give your Providers truthful, accurate, and complete information, including care you receive elsewhere.

10. Your Consent

By accepting this consent, you confirm that you have read and understand this information, that you have had the opportunity to ask questions and have them answered, and that you voluntarily consent to receive care from Alpha Hormones Inc. through telehealth.