Telehealth Informed Consent

Effective Date: 2026-08-01 Last Updated: 2026-05-06 Version: 1.0

This Telehealth Informed Consent (the “Consent”) is a clinical document, distinct from the Terms of Service. You will be presented with this Consent and asked to provide affirmative, recorded acknowledgment before any clinical interaction with the Practice (defined below) on the Halftime Health platform. Acceptance of the Terms of Service alone does not constitute informed consent for telehealth services.

This Consent is written to satisfy the federally relevant elements of telehealth informed consent and the most restrictive requirements that apply across the U.S. states in which the Halftime Health platform is offered. Section 13 (Additional state-specific elements) addresses materially different state requirements that apply to residents of, or patients located in, certain states.

This Consent is between you (the “Patient”) and [Clinical Affiliate PLLC Name] (the “Practice”), the independent professional medical entity, managed by OpenLoop Health, Inc. under a management-services arrangement, whose licensed clinicians provide clinical services on the Halftime Health platform.

Halftime Health LLC (“Halftime Health”) operates the technology, member experience, and customer-support layer of the platform. Halftime Health is a HIPAA Business Associate of the Practice; it is not your healthcare provider and does not practice medicine. Your patient-clinician relationship is with the Practice and the individual clinician who evaluates you.

2. What telehealth is

“Telehealth” means the delivery of healthcare services using electronic and telecommunications technologies — including secure messaging, asynchronous (store-and-forward) clinical evaluation, video visits, voice visits, and remote monitoring — between a clinician and a patient who are not in the same physical location.

Telehealth services on the Halftime Health platform may include:

Asynchronous (store-and-forward) intake review. You complete a digital intake; a licensed clinician of the Practice reviews it without a real-time conversation, and may then prescribe, request more information, request a synchronous visit, or decline to prescribe.
Synchronous video or voice visits. You and the clinician interact in real time. Synchronous video is required for any protocol where state law or the Practice’s clinical policy requires it (including hormone-optimization protocols, certain GLP-1 protocols, and any state in which asynchronous-only evaluation is not permitted for a given protocol).
Voice-assisted intake. You may opt in to an AI-assisted voice intake conducted by an AI agent operating under a HIPAA Business Associate Agreement; a licensed clinician of the Practice reviews the resulting transcript and intake summary before any clinical decision is made.
Asynchronous follow-up. Secure messaging with a clinician about your protocol, side effects, or adjustments.
Bloodwork ordering and review. Ordering laboratory panels through a partner laboratory and reviewing results with a clinician.
Prescription review and electronic prescribing to a licensed dispensing pharmacy.

The Practice does not prescribe controlled substances through the Halftime Health platform.

3. Benefits and limitations of telehealth

3.1 Potential benefits

Convenient access to clinicians from your home.
Reduced travel, time off work, and exposure to other patients.
Continuity of care across geographies, within states where the Practice is licensed.
Faster access to evaluation and prescription where clinically appropriate.

3.2 Limitations

Your clinician cannot perform a hands-on physical examination. Some clinical signs and conditions can only be assessed in person.
Your clinician relies on the accuracy of the information you provide. Inaccurate, incomplete, or outdated information can lead to an inappropriate recommendation.
Technology can fail. Connections may drop, audio or video may be poor, or messages may not deliver. We will reschedule or use an alternate channel if a failure prevents an effective evaluation.
The Service is not appropriate for medical emergencies (see Section 6).
The clinician may determine that your condition cannot be safely evaluated or treated by telehealth and may decline to provide a recommendation, decline to prescribe, or refer you for in-person care. You will not be charged for clinical services where your subscription is refunded as a result.
Telehealth services may not be available to you if you are physically located outside an eligible state at the time of the encounter, even if your billing address is in an eligible state.

4. Risks of telehealth

By proceeding, you acknowledge that you understand the following risks of telehealth:

Diagnostic uncertainty. Without a physical examination, the differential diagnosis may be broader, and the clinician may rely more heavily on your self-reported history.
Delays. Asynchronous review and shipment logistics may introduce delays compared to in-person care, particularly for prescriptions that require synchronous video, additional records, or laboratory results.
Technical failures. Delays, dropped sessions, or message-delivery issues may affect the quality of care.
Privacy and security. Although we use industry-standard safeguards, transmissions over the internet and over wireless networks carry residual risk of interception, unauthorized access, or breach. See the Notice of Privacy Practices at /legal/hipaa-notice.
Recording and storage. Voice transcripts, secure messages, SOAP notes, and prescription records are stored as part of your medical record. Voice intake call audio is not retained by default (audio is dropped in flight); transcripts are retained as required by law and clinical practice.
Out-of-pocket cost. Telehealth services on this platform are cash-pay only and are not billed to insurance. You are responsible for the full cost. Compounded medications are not eligible for insurance reimbursement and are not FDA-approved.
No guarantee of outcome. Treatment may not produce the results you expect. The Practice makes no guarantee of any specific clinical outcome.
Side effects and adverse events. All medications carry the risk of side effects and adverse events. Specific risks for any prescribed protocol will be reviewed with you in a per-protocol informed-consent document before initiation.

5. Alternatives to telehealth

You always have the right to seek in-person medical care from a clinician of your choosing. Alternatives include your primary-care physician; an in-person specialist (endocrinology, urology, gynecology, dermatology, sports medicine, etc.); an urgent-care clinic or emergency department for time-sensitive concerns; or a hospital-based clinic or academic medical center.

Choosing telehealth is voluntary. You may revoke this Consent at any time and seek in-person care without penalty (other than fees for services already rendered).

6. Emergencies — telehealth is not for emergencies

This Service is not for medical emergencies.

If you are experiencing a medical emergency — including chest pain, difficulty breathing, severe allergic reaction, signs of a stroke, severe bleeding, severe abdominal pain, anaphylaxis, suicidal thoughts or thoughts of self-harm, or a life-threatening reaction to a medication — stop using the Service and:

Call 911 immediately, or
Go to the nearest emergency room.

If you are experiencing thoughts of self-harm or suicide:

Call or text 988 (Suicide & Crisis Lifeline) in the United States.
Stay with someone you trust, or go to your nearest emergency department.

The Practice cannot provide emergency services through this platform and may not be available 24/7. Do not use secure messaging to communicate an emergency.

7. Identity and location verification

To comply with telehealth licensure rules:

We will verify your identity at intake and at clinical encounters as required.
You agree to confirm the U.S. state in which you are physically located at the time of any synchronous encounter, and to disclose any travel that places you outside an eligible state.
The Practice may decline to render services if you are physically located outside an eligible state.
Identity-verification vendors used to confirm your identity include Persona, Stripe Identity, and Stripe Radar.

8. Recording and storage of telehealth encounters

The Practice records and stores certain encounters as part of your medical record:

Asynchronous intake responses are stored as part of your medical record.
Voice intake transcripts are stored as part of your medical record. Voice intake call audio is not retained by default. If you opt into a tiebreaker review mode, voice intake audio is retained for 30 days and then deleted.
Secure messages, SOAP notes, prescription records, and lab results are stored as part of your medical record.
Synchronous video visits are not video-recorded by default. Where the Practice’s clinician determines that recording a specific synchronous video visit is clinically necessary, we will obtain your separately documented consent at the start of that visit, and the recording will be retained as part of your medical record.

In states that require all parties to consent to recording (including, as of the Effective Date, California, Connecticut, Delaware, Florida, Illinois, Maryland, Massachusetts, Michigan, Montana, Nevada, New Hampshire, Oregon, Pennsylvania, Vermont, and Washington), by proceeding you consent to the recording and storage practices described in this Section. The clinician will obtain a separate, contemporaneous consent on the record at the start of any synchronous encounter that is being recorded.

9. Voice-assisted (AI) intake — opt-in

If you opt in to voice-assisted intake:

A voice agent powered by ElevenLabs Conversational AI, operating under a HIPAA Business Associate Agreement, will conduct an intake conversation with you.
The transcript is reviewed by a licensed clinician of the Practice before any clinical recommendation is made.
The voice agent does not diagnose, prescribe, or render medical advice. It collects information for clinician review.
You will be informed at the start of the conversation that you are speaking with an AI voice agent.
You may decline voice-assisted intake and use the web-form intake instead, with no impact on your access to clinical services.

In states with AI-in-healthcare-specific statutes (including California Assembly Bill 3030 and similar measures), the AI disclosure described above and the in-flow disclosures we provide are designed to satisfy those requirements. See Section 13 (Additional state-specific elements).

10. Prescriptions and dispensing

If a clinician prescribes a medication:

The prescription is sent electronically to the dispensing pharmacy.
Your prescription may be filled by a 503A compounding pharmacy (BoomRx as primary, MediVera as backup) or by another licensed pharmacy as clinically appropriate.
Compounded medications are not FDA-approved. They are prepared by a licensed pharmacy based on a clinician’s prescription for an individual patient. The FDA has not reviewed these preparations for safety, efficacy, or quality.
A clinician may decline to prescribe if it is not clinically appropriate. Refund handling for the medication portion of any subscription is governed by the Terms of Service and the Refund Policy.
You will receive specific risks, benefits, and instructions for each prescribed protocol in a per-protocol informed-consent document at the time of prescription.

11. Continuity of care and your responsibilities

You agree to:

Provide accurate, complete, and current information at intake and through ongoing care.
Inform the Practice of any other providers, prescriptions, supplements, or treatments you are receiving.
Inform your primary-care provider of treatment received through the Service so they can maintain a complete record. The Practice will, on your written authorization, provide a clinical summary to your primary-care provider.
Promptly report adverse events, side effects, or new symptoms to the Practice through secure messaging.
Seek in-person care if your condition deteriorates or if your clinician recommends it.
Follow the prescribed protocol as directed, including dose, frequency, route of administration, and storage instructions.

Failure to provide accurate information or follow the prescribed protocol may result in inappropriate recommendations or harm and may, in the Practice’s clinical judgment, terminate the patient-clinician relationship.

12. Fees

Telehealth services on the Halftime Health platform are cash-pay and not billed to insurance. Fees are governed by the Terms of Service and the pricing displayed on the Halftime Health website at the time of your purchase. Current standard fees include:

Subscription tiers: Foundation $199/mo, Optimizer $349/mo, Elite $549/mo.
Halftime Baseline onboarding bloodwork panel: $249.
Per-protocol pricing for premium add-ons and certain protocols (including GLP-1 protocols where the medication COGS is variable) is confirmed during your physician consultation and at checkout.

Refund handling is governed by the Terms of Service and the Refund Policy.

13. Additional state-specific elements

This Section 13 lists state-specific elements that materially supplement the federally and generally relevant elements above. If the state in which you are located is not listed, the elements above apply without state-specific modification.

13.1 Texas

A valid practitioner-patient relationship may be established by telehealth where the patient gives informed consent and the clinician complies with the standard of care applicable to in-person care, consistent with Texas Occupations Code Chapter 111 and 22 Texas Administrative Code §174. You may file a complaint with the Texas Medical Board, P.O. Box 2018, Austin, TX 78768, or at https://www.tmb.state.tx.us/.

13.2 California

You have the right to receive a copy of this Consent and your medical record. The Practice will obtain a separate verbal or written consent on the record before any synchronous encounter is recorded. If you receive an AI-generated communication on the platform, the AI disclosure set out in Section 9 satisfies the disclosure required by California Assembly Bill 3030. You may file a complaint with the Medical Board of California at https://www.mbc.ca.gov/.

13.3 New York

The Practice will document your verbal or written consent to telehealth in your medical record at or before the first encounter, consistent with 10 NYCRR Part 400. You may file a complaint with the New York State Office of Professional Medical Conduct at https://www.health.ny.gov/professionals/doctors/conduct/.

13.4 Florida

Telehealth services to Florida residents are provided in compliance with Florida Statutes Chapter 456.47. The Practice’s clinicians are registered with the Florida Department of Health where required. You may file a complaint with the Florida Department of Health at https://flhealthsource.gov/.

13.5 Arizona

Telehealth services to Arizona residents are provided in compliance with Arizona Revised Statutes §36-3602. The clinician will obtain your verbal or written informed consent before delivering telehealth services and will document the consent in your medical record. You may file a complaint with the Arizona Medical Board at https://www.azmd.gov/.

In addition to the states listed in Section 8, residents of Connecticut, Delaware, Massachusetts, Michigan, Nevada, New Hampshire, Oregon, Pennsylvania, and Vermont are subject to that state’s two-party-consent recording rules. By proceeding, you consent to the recording and storage practices described in Section 8. Your clinician will, where applicable, restate that consent on the record at the start of any synchronous encounter that is being recorded.

You have the right to:

Refuse telehealth services and seek in-person care without penalty.
Withdraw this Consent at any time by writing to privacy@halftime.health or by canceling your subscription. Withdrawal is prospective and does not affect services already rendered.
Receive a copy of this Consent.
Receive a copy of your medical record consistent with your rights under HIPAA (see /legal/hipaa-notice).
File a complaint with the Practice, with the relevant state medical board (see Section 13), or with the U.S. Department of Health and Human Services Office for Civil Rights.

15. Acknowledgment

By clicking “I consent” or by using telehealth services on the Halftime Health platform, you acknowledge that:

You have read and understand this Consent.
You have had the opportunity to ask questions and to seek the advice of an in-person clinician.
You voluntarily consent to receive telehealth services from the Practice on the terms described in this Consent.
You meet the eligibility requirements set out in the Terms of Service, including being at least 18 years of age and a resident of an eligible state.
You understand that telehealth has limitations and risks, and that telehealth is not a substitute for emergency care.
The information you provide is true, accurate, and complete to the best of your knowledge.

16. Contact

[Clinical Affiliate PLLC Name] c/o Privacy Officer Halftime Health LLC, 600 W. 6th Street, Suite 400, Fort Worth, TX 76102 Email: privacy@halftime.health

For platform support: support@halftime.health

1. The parties to this Consent