Consent to Treatment via Telehealth

I understand that KindleeRx, LLC ("KindleeRx", "Kindlee", "we", "us", "our") affiliated healthcare providers ("Provider Entities") treat patients via telehealth, and I wish to be treated via telehealth. I understand that my telehealth treatment may involve the following (collectively "telehealth visit"):

1. Electronic creation and transmission of medical records, photo images, personal health information, or other data between me as the patient and Provider Entities; and

2. Interactions between me and Provider Entities via data communications (including store and forward and synchronous technology); and

3. I understand there are potential risks to a telehealth visit, including interruptions, unauthorized access which could disclose my health information, and technical difficulties. I understand that Provider Entities or I can discontinue the treatment via telehealth visit if it is felt that the situation warrants.

4. I understand that my health information as part of the telehealth visit may be shared with other individuals or entities for technological and billing purposes and any information collected by Provider Entities as part of this telehealth visit will be used for analyzing my health, possible treatments, to conduct follow-up activities with me, including to offer other Kindlee products and services to me, and will be used further as stated in the Kindlee Privacy Policy.

5. I understand that the Website is not a substitute for the in-person treatment or advice of my primary care physician or any other qualified healthcare professional.

6. I understand that I should never delay seeking advice from any other health professionals if advised to do so by Provider Entities, or if I have any concerns.

7. I understand that Kindlee does not independently verify the inactive or base ingredients in any recommended or sold product. It is my responsibility to review those ingredients as listed on the product packaging.

8. I understand that if I have an emergency health issue of any nature, I should call my local emergency medical number or take such other action as I deem necessary.

9. I understand that Kindlee may receive compensation for technology or administrative services provided to affiliated healthcare providers.

10. I understand that I have the right to request that the Medical Record established with Kindlee be sent to my primary healthcare provider. I may request this by messaging us through the platform. If you are having trouble accessing the platform, you may email us at support@kindleerx.com.