Consent to Care

Who Provides Your Care

Your medical care — including telehealth visits, lab orders, and any treatment plan — is provided by Biomarker Health Winter Garden FL 1 LLC, a medical practice, and its licensed clinicians ("the Practice," "we," "us"). The website, patient portal, and technology platform are operated by Biomarker Health Holdings Inc., which provides administrative and technology services to the Practice and does not practice medicine.

This consent explains two things so you can decide whether to receive care this way: care by telehealth (Part A) and laboratory testing ordered on your behalf (Part B). Please read both parts and ask us anything before you agree.

Part A — Care by Telehealth

What Telehealth Is

Telehealth is the delivery of health care using secure, two-way audio and video technology instead of an in-person visit. Through the platform, a licensed clinician can review your information, talk with you by video, evaluate you, and — where clinically appropriate — order labs and create a treatment plan, including hormone or peptide therapy.

What to Expect

• Your visit takes place by secure video with a clinician licensed in the state where you are located.
• The clinician provides the same standard of care you would receive in person, with the same privacy protections under HIPAA.
• You can ask questions, pause, or stop the visit at any time.
• The clinician may decide that telehealth is not appropriate for your situation and may recommend an in-person visit or refer you elsewhere.

Benefits

Telehealth can give you greater convenience and access to care without travel, while allowing your clinician to review your intake and lab results and manage your plan over time.

Risks and Limitations

Telehealth also has limitations you should understand:

• A clinician cannot physically examine you, which in some cases can limit evaluation and may make certain diagnoses or treatments unsuitable by telehealth.
• Technology can fail — connections may drop, audio or video quality may be poor, or a visit may be delayed or interrupted.
• Despite strong safeguards, no electronic transmission is perfectly secure, and there is a small risk that information could be intercepted or accessed improperly.
• Information you provide may be incomplete or inaccurate, which can affect the clinician's recommendations.

If a problem during a visit affects your care, your clinician will discuss next steps with you.

Prescribing by Telehealth

Some medications, including certain hormones such as testosterone, are controlled substances and are subject to additional federal and state requirements for telehealth prescribing, which may require an in-person evaluation. Your clinician will follow the rules that apply at the time of your care.

Alternatives

You have the right to receive care in person rather than by telehealth. If you prefer an in-person visit or if telehealth is not appropriate for you, we will discuss available options, which may include scheduling at our clinic or referral to another provider.

Recording

We do not record telehealth visits except with your separate written consent or as required by law. You may not record a visit without the clinician's consent.

Technology and Location

To use telehealth you need a device with a camera, microphone, and a stable internet connection. You must be physically located in a state where your clinician is licensed at the time of the visit. Telehealth may be unavailable in some locations due to licensing and regulatory requirements.

Part B — Laboratory Testing

What You Are Authorizing

By agreeing below, you authorize a licensed clinician of the Practice to review your intake and, where clinically appropriate, sign an order for laboratory testing on your behalf — including your biomarker panel — and to direct that testing to a certified laboratory. You also authorize the laboratory to perform the ordered tests and to return your results to your clinician and to your account.

A clinician-patient relationship is established for the purpose of reviewing your intake and ordering and interpreting your labs.

How It Works

1. You complete your intake, providing accurate and complete health information.
2. A licensed clinician reviews your intake and signs the lab order if appropriate.
3. Your sample is collected at a patient service center, or at your home or office by a licensed phlebotomist. Blood draws are not performed at our clinic.
4. A certified laboratory analyzes your sample.
5. Results are returned to your clinician and posted to your account, where you can view them.

What the Testing Involves

Most panels require a blood draw. Drawing blood is a routine procedure with minor and uncommon risks, which can include discomfort, bruising, bleeding, lightheadedness, or, rarely, infection at the draw site. Your clinician or the draw staff will discuss any specific risks that apply to you.

How Your Results Are Used

• Results are made available to your treating clinician and to you through your account.
• Lab results are one input into clinical decision-making and must be interpreted by a qualified clinician. Do not self-diagnose or self-treat based on your results.
• Your clinician will use your results, together with your history and goals, to discuss whether any treatment plan is appropriate.

Clinical Judgment Governs Your Care

Whether any specific test is ordered, and whether you are prescribed any medication or accepted for any treatment plan, is determined solely by your clinician's professional judgment and applicable law. Submitting an intake, completing labs, or paying a fee does not guarantee that any particular test will be ordered or that you will receive any diagnosis, treatment, or prescription. A clinician may decline to treat you, discontinue treatment, or refer you elsewhere at any time.

Not for Emergencies

Telehealth and laboratory services are not for medical emergencies. If you are experiencing an emergency, call 911 or go to the nearest emergency room. If you are in crisis or having thoughts of self-harm, call or text 988.

Privacy and How Information Is Shared

Information shared during your care is protected under the same laws that apply to in-person care, including HIPAA. To perform and process your testing, we share necessary information with the laboratory and, if a treatment plan results, potentially with a pharmacy; these parties handle your protected health information consistent with HIPAA and, where applicable, under Business Associate Agreements. Only those involved in your care and operations will have access to your information, except as permitted or required by law. Our practices are described in full in our Privacy Policy and Notice of Privacy Practices.

Financial Responsibility

You are responsible for the fees associated with your visits, testing, and any related services, as disclosed before you are charged. Laboratory fees may be included in your membership price depending on which biomarkers you order and which membership level you select; additional biomarkers beyond what your plan includes may be billed separately. The Services are cash-pay and are not billed to insurance.

Your Rights

• You may ask questions at any time — before, during, or after any visit or test.
• You may stop a visit, decline telehealth care, or decline any recommended test at any point.
• You may withdraw this consent at any time, in writing, without affecting your right to future care by other means.
• Withdrawal is not retroactive: it does not apply to care already provided or to testing already ordered, performed, or in process.

Consent

I have read and understand this Consent to Care. I have had the opportunity to ask questions and have them answered. I understand the benefits, risks, and limitations of telehealth and of laboratory testing, and the alternatives available to me.

I consent to receiving care by telehealth from Biomarker Health Winter Garden FL 1 LLC and its licensed clinicians, and I authorize a licensed clinician of the Practice to order laboratory testing for me and the laboratory to perform that testing and return my results to my clinician and to my account.

Patient name: ______________________________

Signature: ______________________________ Date: ____________

(For online enrollment, this consent is captured electronically with a date-and-time stamp and the version number of this document.)