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AUTHORIZATION TO USE AND DISCLOSE MEDICAL INFORMATION AND CONSENT TO TELEHEALTH

OPEN PAYMENTS NOTICE

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Last Updated: May 26, 2026

BY CLICKING “I AGREE,” CHECKING ANY RELATED BOX TO SIGNIFY YOUR ACCEPTANCE, USING ANY OTHER ACCEPTANCE PROTOCOL PRESENTED THROUGH THE WEBSITE OR SERVICES, OR OTHERWISE AFFIRMATIVELY ACCEPTING THIS CONSENT, YOU ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, AND AGREED TO BE BOUND BY THIS CONSENT.

IF YOU DO NOT AGREE TO THIS CONSENT, DO NOT USE THE WEBSITE OR SERVICES PROVIDED THROUGH THE APOTHECARY.

IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, CALL 911 IMMEDIATELY.

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INFORMED CONSENT REGARDING TELEHEALTH SERVICES

PURPOSE

The purpose of this Telehealth Consent (“Consent”) is to provide you with information regarding the use of telehealth technologies and obtain your informed consent to receive healthcare-related services through the online platforms, communications systems, and services operated by The Apothecary (“TAP Rx Care,” “we,” “our,” or “us”).

Telehealth services may be provided by licensed physicians, nurse practitioners, physician assistants, pharmacists, counselors, wellness providers, and other healthcare professionals (“Providers”).

In this Consent, “you” and “your” refer to the patient using the services, including a parent or legal guardian acting on behalf of a minor where permitted by applicable law.

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USE OF TELEHEALTH

Telehealth involves the use of electronic communications and technology to deliver healthcare services when the patient and Provider are not physically located in the same place.

Telehealth services may include:

  • Medical evaluations

  • Wellness consultations

  • Prescription management

  • Follow-up care

  • Laboratory review

  • Patient education

  • Communication through secure messaging, phone, video conferencing, email, or electronic forms

Alternative treatment options, including in-person care, may be available to you at any time.

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ANTICIPATED BENEFITS

Potential benefits of telehealth services may include:

  • Increased access to healthcare services

  • Improved convenience and efficiency

  • Reduced travel requirements

  • Faster communication with Providers

  • Easier access to follow-up care and medication management

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POTENTIAL RISKS

Potential risks associated with telehealth include, but are not limited to:

  • Technical failures or interruptions

  • Delays in evaluation or treatment

  • Security or privacy breaches

  • Incomplete medical assessments due to lack of physical examination

  • Technology errors or software malfunctions

  • Inaccurate or incomplete medical records

  • Miscommunication caused by electronic systems

You understand that no specific medical outcome or result can be guaranteed.

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EMERGENCY SITUATIONS

Telehealth services are not intended for emergency medical situations.

If you are experiencing:

  • Chest pain

  • Difficulty breathing

  • Severe allergic reactions

  • Suicidal thoughts

  • Medical emergencies

Call 911 immediately or seek emergency medical care.

Providers using telehealth platforms may not respond immediately to communications submitted through the website or messaging systems.

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DATA PRIVACY AND SECURITY

The Apothecary utilizes commercially reasonable safeguards designed to protect the confidentiality and security of your personal and medical information.

However, you understand:

  • Electronic communications may not be completely secure

  • Internet transmissions may carry inherent security risks

  • Absolute confidentiality cannot be guaranteed

Protected health information may be disclosed:

  • For treatment purposes

  • For payment and healthcare operations

  • As required by law

  • As otherwise permitted under applicable privacy laws and HIPAA regulations

Please review our Privacy Policy and HIPAA Notice of Privacy Practices for additional information.

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LABORATORY SERVICES

Certain services available through The Apothecary may involve laboratory testing provided by affiliated or third-party laboratories.

You understand:

  • Laboratory testing may require blood draws or at-home collection kits

  • Risks associated with testing may include bruising, discomfort, infection, inaccurate results, false positives, false negatives, or inconclusive results

  • The Apothecary and affiliated Providers cannot guarantee the accuracy or reliability of laboratory results

  • Laboratory services are voluntary

You acknowledge that you are responsible for discussing laboratory results with your primary healthcare provider and obtaining appropriate follow-up care when necessary.

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PRESCRIPTION SERVICES

Prescriptions issued through telehealth services are subject to:

  • Medical necessity

  • Provider discretion

  • State and federal regulations

  • Pharmacy review procedures

Providers reserve the right to deny treatment or prescriptions when clinically inappropriate or prohibited by law.

You understand that you may choose to use any pharmacy of your choice to fill legally valid prescriptions when permitted by law.

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ELECTRONIC COMMUNICATIONS CONSENT

By using the services, you consent to receive communications electronically, including:

  • Appointment reminders

  • Prescription notifications

  • Billing communications

  • Follow-up messages

  • Wellness communications

  • Customer support responses

Communications may occur through:

  • Email

  • SMS/text messaging

  • Telephone

  • Secure messaging systems

Standard message and data rates may apply.

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OPEN PAYMENTS NOTICE

For informational purposes only, a link to the federal Centers for Medicare & Medicaid Services (CMS) Open Payments website is provided below.

The federal Physician Payments Sunshine Act requires that information regarding certain payments and transfers of value made by pharmaceutical manufacturers and medical device companies to physicians and teaching hospitals be made available to the public.

The Open Payments database can be accessed at:

https://openpaymentsdata.cms.gov

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YOUR ACKNOWLEDGMENTS

By accepting this Consent, you acknowledge and agree that:

  • Healthcare services provided through The Apothecary may be delivered through telehealth technologies.

  • Your Provider may determine that telehealth is not appropriate for your condition.

  • Technology used in telehealth services may contain errors, interruptions, or limitations.

  • Telehealth is an evolving area of healthcare and may involve technologies not specifically described in this Consent.

  • No guarantees have been made regarding treatment outcomes.

  • You have had the opportunity to ask questions regarding telehealth services.

  • You may withdraw consent to telehealth services at any time by discontinuing use of the services and providing written notice where applicable.

  • You are responsible for providing accurate and complete medical information.

  • You understand that prescriptions and treatments are subject to Provider discretion and applicable laws.

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CONTACT INFORMATION

 The Apothecary
435 FM 1092 Rd, Suite N
Stafford, Texas 77477
Phone: (281) 208-7218
Email: Info@taprxcare.com

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