CONSENT TO TELEHEALTH SERVICES

Introduction

Thank you for choosing Luma Meds, operated by Happyscale Wellness Corp ("Luma Meds")! You are viewing this form because you have elected to engage in asynchronous telemedicine visits with a licensed healthcare practitioner through the Luma Meds platform. Your healthcare practitioner is licensed in your state and authorized to provide telehealth services where permitted by law.

By clicking "I Agree," I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THE TERMS PRESENTED BELOW, UNDERSTAND THE RISKS AND BENEFITS OF ASYNCHRONOUS TELEMEDICINE, AND HEREBY GIVE MY INFORMED CONSENT TO PARTICIPATE IN ASYNCHRONOUS TELEMEDICINE UNDER THESE TERMS.

What Is Telemedicine?

Telemedicine is the delivery of healthcare services, including examination, consultation, diagnosis, and treatment, through electronic communication technologies when you (the patient) are located in a different location than your healthcare practitioner. Telemedicine allows you to receive treatment from a healthcare practitioner without having to travel to another location or schedule a separate appointment and may help reduce wait times that could otherwise occur during an in-person visit.

What Is Asynchronous Telemedicine?

Asynchronous telemedicine is one way to deliver telemedicine. Asynchronous communication is often referred to as "store-and-forward" communication, where participants submit and collect data at different times.

An example of asynchronous communication is a telemedicine encounter with a healthcare practitioner that involves sending photos, video, questionnaires, or other communications electronically.

The Luma Meds platform allows for asynchronous telemedicine services including:

• Text-based healthcare practitioner-patient interactions through SMS and MMS communications.
• Secure information collection through electronic questionnaires and other store-and-forward technologies.

What Are the Possible Risks of Using Asynchronous Telemedicine?

As with any medical treatment, there are potential risks associated with the use of asynchronous telemedicine.

• Delays in medical evaluation, consultation, or treatment due to equipment failure, internet outages, poor data quality, or other technical issues.
• Security protocols could fail, causing a breach of privacy involving personal medical information.
• If you do not provide complete and accurate information regarding your medical history, diagnoses, treatments, medications, supplements, allergies, or symptoms, adverse outcomes, medication interactions, allergic reactions, or treatment delays may occur.
• Asynchronous telemedicine services are NOT emergency services and your information WILL NOT be monitored 24 hours per day, 7 days per week.

IF YOU BELIEVE YOU ARE EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY OR SEEK IMMEDIATE EMERGENCY MEDICAL CARE.

THE CARE YOU RECEIVE WILL BE AT THE SOLE PROFESSIONAL DISCRETION OF THE HEALTHCARE PRACTITIONER TREATING YOU. No guarantee is made regarding diagnosis, treatment, or prescription of any medication.

Your Rights and Acknowledgements

• You have the same privacy rights during a telemedicine visit that you would have during an in-person visit.
• Identifiable images or information obtained during a telemedicine encounter will not be disclosed to researchers or third parties without your authorization unless otherwise permitted or required by law.
• Asynchronous telemedicine may involve electronic communication of your medical information to healthcare practitioners who may be located in another city or state.
• You understand that you may receive benefits from telemedicine services, but no specific outcome can be guaranteed.
• Information submitted through the platform may become part of your medical record.
• You may withdraw your consent to telemedicine at any time by contacting Luma Meds.
• Your healthcare information may be shared as permitted by applicable law, including HIPAA and state privacy laws.

Healthcare information may be disclosed when required by law, including:

• When a valid court order is issued.
• To report suspected abuse, neglect, or domestic violence.
• To prevent or reduce a serious threat to health or safety.
• For other purposes authorized or required by law.

Call, Email, and Text Message Consent

You expressly consent to allow Luma Meds, affiliated healthcare practitioners, pharmacies, and service providers acting on behalf of Luma Meds to call, email, or text you regarding appointments, prescriptions, treatment plans, account notifications, healthcare services, and related communications using the contact information you provide.

Communications may include SMS and MMS text messages. Standard message and data rates may apply based on your mobile carrier plan.

You may withdraw your consent to receive non-essential communications at any time by contacting:

Duration of Consent

This Telehealth Consent shall remain effective throughout your participation in services provided through the Luma Meds platform unless withdrawn by you or terminated as required by applicable law.