Above Health – Informed Consent for Telehealth Services

Effective Date: August 13, 2025

This Informed Consent outlines your rights, benefits, and potential risks of receiving healthcare via telehealth through Above Health and its affiliated medical providers (Saba Haq Above Medical Group). Please review this document carefully before participating in telehealth services.

1. Age Requirements and Guardian Consent

1.1 Adult Patients

If you are 18 years of age or older, you may consent to your own telehealth services by agreeing to this document.

1.2 Minor Patients

If the patient is under 18 years of age:

• The parent or legal guardian MUST provide consent for all telehealth services
• The consenting adult must have documented legal authority to make healthcare decisions for the minor
• The parent/legal guardian must be present during telehealth consultations unless otherwise directed by the healthcare provider
• We may request proof of guardianship or legal authority

1.3 Verification of Authority

By providing consent for a minor, you represent and warrant that you are:

• The biological or adoptive parent of the minor, OR
• The court-appointed legal guardian of the minor, OR
• Otherwise legally authorized to consent to medical treatment for the minor

Providing false information about your legal authority is prohibited and may result in termination of services and potential legal action.

2. Nature of Telehealth

Telehealth involves the delivery of healthcare services using interactive audio, video, or other electronic media. You will communicate with clinicians remotely and may share medical history, images, or diagnostic data electronically.

For minor patients, the parent/legal guardian will:

• Facilitate communication between the minor and the healthcare provider
• Ensure the minor's cooperation during consultations
• Help the minor understand and follow treatment recommendations

3. Potential Risks

• Technical failures, such as poor internet connection, may limit service quality
• In rare cases, incomplete transmission of information could result in suboptimal clinical decisions
• Although security measures are in place, data breaches are a potential risk
• For minors, there may be limitations in physical examination that could affect diagnosis

4. Benefits

• Improved access to medical care without the need for in-person visits
• Convenience and scheduling flexibility
• Real-time care and monitoring when appropriate
• For minors, reduced anxiety from receiving care in familiar surroundings

5. Confidentiality and Privacy

5.1 General Privacy Protections

Telehealth communications are protected under HIPAA and applicable privacy laws. We use encryption and secure technologies to safeguard your information. Full details are available in our Privacy Policy.

5.2 Minor Patient Privacy

• Parents/legal guardians generally have access to their minor child's health information
• Some states grant minors certain privacy rights for specific types of healthcare
• Healthcare providers will discuss any applicable privacy rights with both the guardian and minor patient as appropriate
• In some cases, providers may request private consultation time with adolescent patients, with guardian consent

6. Alternative Options

You have the right to refuse telehealth services and opt for in-person care where available and appropriate. For minor patients, the parent/legal guardian retains this right on behalf of the minor.

7. Patient and Guardian Responsibilities

7.1 All Patients/Guardians Must:

• Provide accurate and complete medical information
• Ensure a secure and private environment for telehealth sessions
• Follow post-visit care instructions and seek in-person care if recommended
• Maintain confidentiality of login credentials and session information

7.2 Additional Guardian Responsibilities for Minor Patients:

• Remain available during the entire telehealth session
• Assist the minor in communicating symptoms or concerns
• Ensure the minor follows all treatment plans and medication instructions
• Monitor the minor for any adverse reactions or changes in condition
• Seek emergency care immediately if the minor's condition worsens
• Update the minor's medical information as needed
• Maintain all follow-up appointments

8. Emergency Situations

In case of emergency:

• Call 911 immediately
• Go to the nearest emergency room
• Do not attempt to use telehealth services

Parents/guardians are responsible for recognizing emergency situations involving minor patients and seeking appropriate emergency care.

9. Consent and Withdrawal

9.1 Providing Consent

By agreeing to this document:

• Adult patients provide informed consent for their own telehealth services
• Parents/legal guardians provide informed consent for minor patients under their care
• You acknowledge understanding all risks, benefits, and responsibilities

9.2 Withdrawal of Consent

You may withdraw consent at any time by notifying Above Health in writing.

• For adult patients: Withdrawal affects only future services
• For minor patients: The parent/legal guardian may withdraw consent on behalf of the minor
• Withdrawal will not affect prior care delivered

10. Documentation and Records

We maintain records of all telehealth consultations. For minor patients:

• Records will indicate the parent/legal guardian who provided consent
• Documentation of guardian authority may be maintained in the patient file
• All records are maintained in accordance with applicable laws and regulations

11. Technology Requirements

You are responsible for:

• Ensuring adequate internet connectivity
• Using a device with audio and video capabilities
• Maintaining privacy during sessions
• For minors, ensuring the technology is set up and functioning before the appointment

12. Contact Information

For questions or concerns regarding telehealth services, contact:

13. Attestation and Agreement

By participating in telehealth services, you confirm that:

• You have read and understood all terms of this Informed Consent
• You have had the opportunity to ask questions about telehealth services
• You voluntarily agree to receive telehealth services
• If consenting for a minor, you have the legal authority to do so
• You understand your responsibilities as outlined in this document
• You agree to comply with all terms and conditions

Electronic Signature Requirements:

• Adult patients must provide their own electronic signature
• For minor patients, the parent/legal guardian must provide their electronic signature
• We may require additional verification of identity and authority

This consent remains in effect unless withdrawn in writing or until the minor patient reaches the age of majority (18 years), at which point new consent must be obtained directly from the patient.