AUTHORIZATION TO USE AND DISCLOSE MY MEDICAL INFORMATION AND CONSENT TO TELEHEALTH
Last Updated: June 11, 2025

BY CLICKING “I AGREE,” CHECKING A BOX, OR OTHERWISE INDICATING YOUR ACCEPTANCE, YOU CONSENT TO THIS AGREEMENT WITH REACH HEALTH INC. ("REACH"). IF YOU DO NOT AGREE, DO NOT USE OUR SERVICES.

AUTHORIZATION TO USE AND DISCLOSE MEDICAL INFORMATION

You authorize Reach and its licensed medical providers and pharmacy partners to use and disclose your medical and personal health information ("Medical Information") for:

• Delivering telehealth services and treatment
• Coordinating prescription fulfillment
• Communicating offers, reminders, or educational materials
• Participating in compliance, safety, or analytics programs

Your information may include sensitive health data such as mental health status, substance use, sexual health, and medications. This information may be used and disclosed to healthcare professionals, pharmacy partners, and administrative staff as necessary.

Re-Disclosure: Once disclosed, your Medical Information may be re-disclosed by others and may no longer be protected by privacy laws.

No Obligation to Sign: You are not required to sign this to receive treatment but doing so helps us deliver efficient care.

Right to Revoke: You may revoke this authorization at any time by contacting us at privacy@reachhealth.com. Revocation does not affect prior actions taken based on your original authorization.

Expiration: This authorization expires one year after the date of signing, unless revoked earlier or otherwise required by law.

CONSENT TO TELEHEALTH SERVICES

Definition: Telehealth allows licensed professionals to evaluate, diagnose, and treat you remotely using secure digital platforms. These interactions may include messaging, video, audio, and medical record sharing.

Benefits:

• Convenient access to licensed professionals
• No need for in-person visits
• Secure communication of your treatment plan and prescriptions

Risks:

• Technology failures or data transmission issues
• Misdiagnosis due to limited physical exam
• Data breaches despite best efforts
• Delayed care or technical limitations

Alternatives: You may seek care in-person or choose other healthcare options at any time.

Emergency Situations: Reach is not appropriate for life-threatening emergencies. If you are experiencing a medical or psychiatric crisis, call 911 or 988 immediately.

PATIENT ACKNOWLEDGMENTS

By agreeing to this document, you acknowledge:

• You consent to care delivered via telehealth
• You may be treated by physicians, nurse practitioners, or physician assistants
• You understand the potential benefits and limitations of telehealth
• You may withdraw your consent at any time
• You are responsible for providing truthful and complete information to Reach
• You may choose to use another provider or pharmacy

DATA SECURITY

We use encryption and industry-standard protections to safeguard your data. While we strive to ensure privacy, no system is completely secure. Your information may be shared only for treatment, payment, and legal compliance.

LABORATORY AND THIRD-PARTY SERVICES

Some prescriptions or care plans may involve third-party laboratories. Reach is not liable for the accuracy or results from these services.

OPEN PAYMENTS NOTICE

The federal Open Payments program tracks financial relationships between drug/device manufacturers and healthcare providers. Learn more at: https://openpaymentsdata.cms.gov

QUESTIONS OR CONCERNS

To request a copy of this Consent or if you have any concerns: Email: support@reachhealth.com
(M–F, 9 AM–5 PM ET)

By using Reach’s platform, you confirm your understanding and agreement with this Consent and Authorization.