Informed Consent for Telehealth Services

Effective Date: March 30, 2026

This document describes the nature, benefits, risks, and limitations of telehealth services provided by InnoCre ("InnoCre," "we," "us," or "our"). By scheduling or participating in a telehealth visit with Innocre, you acknowledge that you have read, understood, and agree to the terms outlined below.

1. Nature of Telehealth Services

Telehealth involves the delivery of healthcare services using electronic communication technologies, including real-time audio and video consultations, secure messaging, and electronic transmission of medical information. Our providers use these technologies to evaluate, diagnose, and treat medical conditions without requiring an in-person office visit.

Innocre provides telehealth services for non-emergency medical conditions including but not limited to: urgent care, primary care, prescription management, and treatment of common acute and chronic conditions. All services are delivered by board-certified, licensed healthcare providers.

2. Benefits of Telehealth

• Convenient access to medical care from your home or any private location
• Reduced travel time, wait times, and exposure to contagious illnesses
• Timely evaluation and treatment for non-emergency conditions
• Ability to consult with a licensed provider regardless of distance, within our licensed states
• Secure and HIPAA-compliant communication platform

3. Risks and Limitations

As with any medical service, telehealth has potential risks and limitations, including but not limited to:

• Technology limitations: Poor internet connectivity, hardware failures, or software issues may interrupt or degrade the quality of your visit. In rare cases, your visit may need to be rescheduled.
• Diagnostic limitations: The provider cannot perform a physical examination. Some conditions may require an in-person visit, lab work, or imaging for accurate diagnosis and treatment.
• Security risks: While we use encrypted, HIPAA-compliant platforms, no electronic communication is entirely risk-free. There is a small possibility of unauthorized access to your health information.
• Delayed treatment: If your condition requires in-person care, there may be a delay in diagnosis or treatment while you are referred to an appropriate facility.

4. Your Rights as a Patient

You have the right to:

• Withdraw your consent and discontinue a telehealth visit at any time without affecting your right to future care
• Request an in-person referral at any time during or after a telehealth consultation
• Ask questions about your diagnosis, treatment plan, medications, or any aspect of your care
• Receive a clear explanation of your treatment options, including the option of no treatment
• Access your medical records in accordance with applicable law
• Have your health information protected under HIPAA and applicable state privacy laws
• File a complaint if you believe your rights have been violated

5. Your Responsibilities

By participating in a telehealth visit, you agree to:

• Provide accurate and complete information about your medical history, current symptoms, medications, and allergies
• Be physically located in one of the states where Innocre is licensed to provide care (Maryland, Washington, or Delaware) at the time of your visit
• Participate in your telehealth visit from a private, safe, and quiet environment
• Follow the treatment plan and instructions provided by your provider, including follow-up care recommendations
• Contact emergency services (911) immediately if you experience a medical emergency before, during, or after your telehealth visit
• Notify Innocre promptly if your condition worsens or does not improve after treatment

6. Identity Verification

To protect your health information and ensure safe prescribing, InnoCre verifies patient identity at multiple points:

• At registration: You must provide your full legal name, date of birth, current residential address, phone number, and email. New patients are required to upload a clear photograph of a valid government-issued photo ID (driver's license, state ID, or passport) to your secure patient portal.
• At each visit: Your provider will visually confirm your identity at the start of every video visit by comparing your appearance to the photo ID on file. Returning patients confirm date of birth and current address before each visit.
• Address verification: Because InnoCre may only treat patients physically located in Maryland, Washington, or Delaware at the time of the visit, your provider will confirm your physical location at the start of every visit. Visits initiated from outside our licensed states cannot proceed.
• Minors: Patients under 18 must be accompanied by a verified parent or legal guardian during the visit. Proof of guardianship may be required.
• Discrepancies: If we cannot verify your identity, the visit may be paused or rescheduled. Repeated failures to verify identity may result in account suspension.

Identity verification information is stored within your encrypted medical record and is never shared except as permitted under HIPAA and applicable law.

7. Emergency Situations

8. Privacy and Confidentiality

InnoCre uses CharmHealth as its electronic health record, secure patient portal, and HIPAA-compliant videoconferencing platform. CharmHealth is HITRUST CSF certified and operates under a Business Associate Agreement with InnoCre. All video visits, messaging, and document exchanges are end-to-end encrypted and conducted within this single platform. Your protected health information (PHI) is handled in accordance with our Privacy Policy and HIPAA Notice of Privacy Practices.

We do not record telehealth visits without your explicit consent. However, clinical documentation is maintained as part of your medical record in compliance with applicable laws and standards of care.

9. Prescriptions and Medications

If clinically appropriate, your provider may prescribe medications based on your telehealth evaluation. Prescriptions will be sent electronically to your preferred pharmacy. Certain medications, including controlled substances, may not be prescribed via telehealth in accordance with federal and state regulations.

It is your responsibility to inform your provider of all medications you are currently taking to avoid adverse drug interactions.

10. Fees and Payment

You are responsible for payment of telehealth services as outlined at the time of booking. Fees are due at or before the time of service. Innocre will provide information about costs prior to your visit. Insurance coverage varies; it is your responsibility to verify telehealth benefits with your insurance provider.

11. Scope and Limitations of Care

Telehealth services are not a replacement for a primary care provider or for all medical conditions. Your provider may determine that your condition requires in-person evaluation, diagnostic testing, or specialist referral. In such cases, you will be advised accordingly and provided with appropriate referral information.

Use of the Innocre website, including browsing health content or submitting forms, does not establish a provider-patient relationship. A clinical relationship is established only upon completion of a telehealth evaluation by a licensed Innocre provider.

12. Regulatory Compliance

InnoCre delivers telehealth services in compliance with applicable federal and state law, including:

• Maryland: Maryland Board of Nursing telehealth standards under COMAR 10.27.21 and the Maryland Telehealth Act (Md. Code Ann., Health-Gen. § 15-141.2)
• Washington: Washington Nursing Care Quality Assurance Commission rules under RCW 18.79 and Washington's telemedicine statutes (RCW 70.41.020 / RCW 48.43.735)
• Delaware: Delaware Board of Nursing rules under 24 Del. Admin. Code 1900 and Delaware's Telehealth Access Preservation and Modernization Act (24 Del. C. §§ 6001–6005)
• HIPAA: Health Insurance Portability and Accountability Act of 1996 (45 CFR Parts 160, 162, 164)
• Controlled substances: Ryan Haight Online Pharmacy Consumer Protection Act of 2008. Consistent with this statute and InnoCre's clinical policy, we do not prescribe controlled substances via telehealth.

Patients must be physically located in Maryland, Washington, or Delaware at the time of service. Care provided outside these states is outside the scope of InnoCre's licensure.

13. Consent to Treat

By scheduling and participating in a telehealth visit with Innocre, you consent to:

• Receive healthcare services via telehealth technology
• The electronic transmission of your medical information as necessary for treatment, payment, and healthcare operations
• The provider's clinical judgment in making diagnostic and treatment decisions
• I understand that treatment recommendations, including prescriptions, are not guaranteed and are based solely on the provider's clinical judgment

This consent remains in effect for all future telehealth visits with Innocre unless you revoke it in writing by contacting us at atulsv@innocre.org.

14. Contact Information

If you have questions about this informed consent document or your telehealth visit, please contact us: