Above Medical P.C. – Medical Services Consent Agreement

Effective Date: October 23, 2025

1. Medical Practice Information

Above Medical P.C. is a California professional corporation specializing in allergy, asthma, and immunology medicine. Our services are provided by licensed physicians, including board-certified allergists and immunologists. By receiving medical services from Above Medical P.C., you ("Patient," "you," or "your") acknowledge and agree to the terms set forth in this Medical Services Consent Agreement ("Agreement").

2. Scope of Medical Services

Above Medical P.C. physicians are qualified to provide the following medical services:

2.1 Allergic Disease Management

• Food Allergy Care: Diagnosis, management, and treatment of food allergies including milk, egg, peanut, tree nuts, soy, wheat, fish, and shellfish allergies.
• Environmental Allergy Treatment: Management of seasonal and perennial allergic rhinitis, including pollen, dust mite, mold, and pet allergies.
• Drug Allergy Evaluation: Assessment and management of medication allergies and adverse drug reactions.
• Insect Allergy Management: Treatment of bee, wasp, fire ant, and other insect sting allergies.
• Contact Dermatitis Care: Evaluation and management of allergic and irritant contact dermatitis.

2.2 Asthma and Respiratory Care

• Asthma Management: Comprehensive care for allergic asthma, occupational asthma, exercise-induced asthma, and aspirin-exacerbated respiratory disease (AERD).
• Pulmonary Function Testing: Spirometry and other breathing tests to assess lung function.
• Medication Optimization: Prescription and management of inhalers, controller medications, and rescue medications.
• Asthma Action Plans: Development of personalized emergency response protocols.

2.3 Immunology Services

• Primary Immunodeficiency Evaluation: Assessment and management of immune system disorders.
• Mast Cell Disorders: Diagnosis and treatment of mastocytosis and mast cell activation syndrome (MCAS).
• Eosinophilic Disorders: Management of eosinophilic esophagitis (EoE) and other eosinophilic conditions.
• Hereditary Angioedema: Specialized care for this rare genetic condition.

2.4 Specialized Testing and Procedures

• Allergy Skin Testing: Skin prick tests, intradermal tests, and patch testing for comprehensive allergy evaluation.
• Challenge Testing: Food challenges, drug challenges, and other controlled exposure testing under medical supervision.
• Immunotherapy Administration: Allergy shots (subcutaneous immunotherapy) and monitoring.
• Oral Immunotherapy (OIT): Food desensitization protocols for appropriate candidates.
• Laboratory Coordination: Ordering and interpretation of specialized allergy and immunology blood tests.

3. Patient Consent to Medical Treatment

By receiving medical services from Above Medical P.C., you voluntarily consent to:

• Medical Examination: Physical examination, medical history taking, and clinical assessment by your attending physician.
• Diagnostic Procedures: Allergy testing, pulmonary function tests, and other diagnostic procedures deemed medically necessary.
• Treatment Interventions: Prescription medications, immunotherapy, emergency care, and other medically appropriate treatments.
• Follow-up Care: Ongoing monitoring, treatment adjustments, and preventive care as recommended by your physician.

4. Specific Allergy and Immunology Risks and Benefits

4.1 Allergy Testing Risks

You understand that allergy testing may involve the following risks:

• Local Reactions: Redness, swelling, itching, or discomfort at test sites that typically resolves within 24-48 hours.
• Systemic Reactions: Generalized allergic reactions including hives, difficulty breathing, or anaphylaxis requiring emergency treatment.
• False Results: Testing may produce false positive or false negative results requiring additional evaluation or repeat testing.
• Medication Interactions: Certain medications may need to be discontinued before testing, potentially affecting your symptoms temporarily.

4.2 Immunotherapy Risks and Requirements

If you receive immunotherapy (allergy shots or oral immunotherapy), you acknowledge the following significant risks:

• Anaphylaxis Risk: Severe, potentially life-threatening allergic reactions that may occur despite appropriate precautions.
• Observation Requirements: You must remain in the medical facility for a minimum of 30 minutes after each injection for monitoring.
• Emergency Preparedness: You must carry prescribed epinephrine auto-injectors and know how to use them properly.
• Protocol Adherence: You must follow all pre-treatment instructions including reporting illnesses, medication changes, and asthma symptoms.
• Long-term Commitment: Immunotherapy typically requires 3-5 years of treatment for optimal results.

4.3 Oral Immunotherapy (OIT) Specific Risks

For patients receiving OIT for food allergies, additional risks include:

• Daily Dosing Reactions: Risk of allergic reactions during daily dose administration at home.
• Eosinophilic Esophagitis Risk: Potential development of EoE as a complication of food immunotherapy.
• Exercise and Cofactor Restrictions: Need to avoid exercise and other trigger factors around dosing times.
• Ongoing Allergen Avoidance: Continued need to avoid accidental exposure to food allergens during treatment.

5. Emergency Care Protocols

You understand and agree to the following emergency care protocols:

• Life-Threatening Emergencies: For anaphylaxis or other life-threatening allergic reactions, you will immediately use your epinephrine auto-injector and call 911.
• Emergency Medication Management: You will carry prescribed emergency medications at all times and ensure they remain current and not expired.
• Action Plan Compliance: You will follow your personalized Allergy Action Plan and share it with family members, caregivers, schools, and workplaces.
• Emergency Contact Information: You will maintain current emergency contact information with our practice and inform contacts of your medical conditions.

6. Patient Responsibilities and Treatment Compliance

As a patient of Above Medical P.C., you agree to:

• Accurate Medical History: Provide complete and truthful information about your medical history, medications, supplements, previous allergic reactions, and family medical history.
• Medication Compliance: Take prescribed medications exactly as directed and report any side effects or concerns immediately.
• Appointment Adherence: Attend all scheduled appointments, arrive on time, and provide 24-hour notice for cancellations when possible.
• Lifestyle Modifications: Implement recommended environmental controls, dietary restrictions, and allergen avoidance measures.
• Symptom Monitoring: Keep accurate records of symptoms, triggers, medication use, and any adverse reactions.
• Insurance and Payment: Provide accurate insurance information and understand your financial responsibilities for care.

7. Limitations of Medical Care

You understand that:

• No Guarantee of Outcomes: Medicine is not an exact science, and no guarantee can be made regarding treatment outcomes or cure of your condition.
• Specialist Referrals: Above Medical P.C. may refer you to other specialists for conditions outside our scope of practice.
• Emergency Limitations: Our practice provides urgent care during business hours but cannot provide 24/7 emergency services. Life-threatening emergencies require immediate emergency room care.
• Treatment Variability: Individual responses to treatment vary, and some patients may not respond to standard therapies.
• Chronic Condition Management: Many allergic and immunologic conditions require long-term management rather than cure.

8. Physician-Patient Relationship

The physician-patient relationship with Above Medical P.C. includes:

• Physician Identification: Your attending physician will be clearly identified and may include supervising physicians, residents, or nurse practitioners under appropriate supervision.
• Shared Decision Making: You have the right to participate actively in all decisions regarding your medical care.
• Second Opinions: You are encouraged to seek second opinions when appropriate and medically indicated.
• Medical Records Access: You have the right to access your medical records in accordance with applicable laws.
• Cultural Competency: You will receive respectful care regardless of race, ethnicity, gender, sexual orientation, religion, or socioeconomic status.

9. Financial Responsibility and Insurance

You acknowledge and agree to:

• Payment Responsibility: You are financially responsible for all medical services provided, regardless of insurance coverage.
• Insurance Verification: You will provide accurate insurance information and understand your plan's coverage, deductibles, and co-payment requirements.
• Prior Authorization: You are responsible for obtaining required prior authorizations from your insurance plan when applicable.
• Non-Covered Services: Payment for services not covered by insurance is due at the time of service.
• Missed Appointments: You may be charged for missed appointments or appointments canceled with less than 24 hours notice.

10. Privacy and Medical Records

Your medical information is protected under:

• HIPAA Compliance: All medical information is handled in accordance with the Health Insurance Portability and Accountability Act.
• California Privacy Laws: Additional protections under California medical privacy statutes.
• Professional Standards: Medical confidentiality standards established by the California Medical Board.
• Notice of Privacy Practices: Detailed information about how we use and disclose your health information is available in our separate Privacy Policy.

11. Quality Improvement and Research

You consent to the use of your de-identified medical information for:

• Quality assurance and improvement activities within Above Medical P.C.
• Medical education purposes for training healthcare professionals (with appropriate privacy protections)
• Medical research studies (with separate informed consent when required by law)
• Public health reporting as mandated by federal and state regulations

12. Medication Prescribing and Monitoring

Regarding prescription medications and treatments:

• Proper Use: You will use all medications exactly as prescribed and not share them with others.
• Adverse Reaction Reporting: You will immediately report any unexpected side effects or allergic reactions to medications.
• Monitoring Compliance: You consent to laboratory testing and monitoring as deemed necessary for medication safety and efficacy.
• Controlled Substances: If prescribed controlled substances, you agree to comply with all DEA regulations and practice policies.
• Emergency Medications: You will maintain current, non-expired emergency medications including epinephrine auto-injectors and understand proper usage.

13. Patient Rights and Responsibilities

13.1 Your Rights

• Receive competent medical care in accordance with professional standards and community standards of care
• Be informed about your diagnosis, treatment options, prognosis, and risks and benefits of proposed treatments
• Participate actively in all decisions about your medical care and give or withhold consent for specific treatments
• Request second opinions at any time and receive assistance with referrals when appropriate
• Access your medical records as provided by state and federal law
• Receive culturally competent care that respects your values, beliefs, and preferences
• File complaints or grievances regarding your care through established procedures without fear of retaliation
• Terminate the physician-patient relationship with appropriate notice

13.2 Your Responsibilities

• Provide honest, complete, and accurate medical information including all symptoms, previous treatments, medications, and supplements
• Ask questions about anything you don't understand regarding your medical condition or treatment plan
• Follow treatment plans, take medications as prescribed, and report problems or concerns promptly
• Maintain scheduled appointments and provide adequate notice for cancellations to allow other patients to be scheduled
• Respect the rights, dignity, and property of other patients, visitors, and practice staff
• Meet your financial obligations for medical services in a timely manner

14. Allergy Testing and Challenge Procedures

For patients undergoing allergy testing or challenge procedures:

• Informed Consent for Each Procedure: Specific procedures will include detailed informed consent explaining individual risks, benefits, and alternatives.
• Pre-Testing Requirements: You will follow all pre-testing instructions including medication discontinuation, dietary restrictions, and symptom reporting as directed.
• Emergency Preparedness: All testing will be performed in a facility equipped with emergency medications and trained personnel to handle severe allergic reactions.
• Post-Testing Monitoring: You will remain under medical observation for the required time period after testing and follow post-procedure instructions.

15. After-Hours and Emergency Coverage

Above Medical P.C. provides:

• Business Hours Coverage: Direct physician access during regular business hours for urgent allergy and asthma-related concerns.
• After-Hours Coverage: On-call physician coverage for urgent medical concerns related to your allergy/immunology care.
• Emergency Protocol: Clear instructions for when to contact our after-hours line versus when to seek immediate emergency room care.
• Emergency Room Coordination: We will coordinate with emergency departments when you receive emergency care for allergic reactions.

16. Coordination with Other Healthcare Providers

With your consent and as medically appropriate, Above Medical P.C. will:

• Communicate with your primary care physician and other specialists involved in your care
• Provide consultation reports and treatment recommendations to your healthcare team
• Coordinate care plans to avoid drug interactions and ensure comprehensive, coordinated treatment
• Share relevant medical information when you seek emergency care for allergic reactions
• Collaborate with schools, workplaces, and other environments to ensure proper allergy management

17. Technology Integration and Digital Health Tools

Above Medical P.C. may utilize digital health tools as part of your medical care:

• Electronic health records for comprehensive medical documentation and care coordination
• Patient portal access for secure communication, test results, and appointment scheduling
• Integration with smart devices for symptom monitoring (subject to separate Device Use Agreement)
• Telehealth services when clinically appropriate (subject to separate Telehealth Informed Consent)
• Laboratory result integration and trending for better care management

18. Regulatory Compliance and Professional Standards

Above Medical P.C. operates in full compliance with:

• California Medical Board: All physicians maintain current California medical licenses and follow all board regulations and continuing education requirements.
• American Board of Allergy and Immunology: Our allergists maintain board certification and follow specialty practice standards and guidelines.
• DEA Regulations: Controlled substance prescribing follows all federal Drug Enforcement Administration requirements and monitoring.
• HIPAA Compliance: All medical information handling meets Health Insurance Portability and Accountability Act requirements.
• CMS and Insurance Regulations: Practice operations comply with Medicare, Medicaid, and insurance company requirements.
• Joint Commission Standards: When applicable, we follow Joint Commission patient safety and quality standards.

19. Malpractice Insurance and Risk Management

Above Medical P.C. maintains:

• Current professional liability (malpractice) insurance coverage meeting California state requirements
• Comprehensive risk management protocols for patient safety and quality improvement
• Quality assurance programs with regular review of patient outcomes and safety indicators
• Incident reporting and analysis procedures for continuous quality improvement
• Peer review processes for maintaining high standards of clinical care

20. Consent Duration and Modifications

This medical services consent:

• Remains in effect for the duration of your physician-patient relationship with Above Medical P.C.
• May be modified with written notice and your agreement to updated terms
• Can be withdrawn by you with written notice, understanding that this may affect the continuation of comprehensive care
• Automatically expires if the physician-patient relationship is terminated by either party with appropriate notice
• Will be updated as needed to reflect changes in medical practice, regulations, or treatment protocols

21. Grievance and Complaint Procedures

If you have concerns about your medical care provided by Above Medical P.C.:

• Direct Communication: First, discuss concerns directly with your attending physician or practice manager for immediate resolution.
• Formal Grievance Process: Submit written complaints to our Chief Medical Officer for formal review, investigation, and response.
• External Reporting: You may file complaints with the California Medical Board, insurance plans, or other appropriate regulatory bodies.
• Patient Advocacy: We will provide assistance in understanding your rights and options for addressing concerns about your care.
• Non-Retaliation Policy: No retaliation will occur for filing legitimate complaints or grievances about your medical care.

22. Integration with Above Health Inc. Technology Services

You understand that Above Medical P.C. and Above Health Inc. work together to provide comprehensive care:

• Separate Entities: Above Medical P.C. provides medical care services while Above Health Inc. provides technology platform services under separate Terms of Service.
• Technology Integration: Your use of digital platforms, smart devices, and mobile applications is governed by additional agreements including our Device Use Agreement and Privacy Policy.
• Clinical Independence: Medical care decisions are made by Above Medical P.C. physicians independently, using clinical judgment and medical expertise.
• Coordinated Care: Both entities collaborate to provide seamless, comprehensive allergy and asthma care while maintaining distinct legal responsibilities and oversight.

23. Contact Information for Medical Services

For questions about medical care, appointments, or this consent agreement:

IMPORTANT ACKNOWLEDGMENT: By receiving medical services from Above Medical P.C., you acknowledge that you have read, understood, and agree to be bound by this Medical Services Consent Agreement. You understand that medical care carries inherent risks and that no guarantee of successful treatment outcomes can be provided. You acknowledge that this agreement covers medical services provided by Above Medical P.C. and is separate from technology services provided by Above Health Inc. under the Terms of Service.