ROW TELEHEALTH. TELEHEALTH INFORMED CONSENT

Effective August 8, 2026

Last Updated: August 8, 2026

This Telehealth Informed Consent (“Consent”) is between you (“you,” “your,” or the “Patient”) and Rely Telehealth Plus, Inc. d/b/a Row Telehealth (“Row Telehealth,” “we,” “our,” or “us”). It explains what telehealth is, how our Services work, the benefits, risks, and limitations of receiving care by telehealth, your rights and responsibilities, and what you are agreeing to. Please read it in full. By checking the acknowledgment box, electronically signing, or proceeding with a telehealth visit, you confirm that you have read, understood, and voluntarily agreed to this Consent. If anything is unclear, contact us at support@rowtelehealth.com before proceeding.

1. Definitions

• “Telehealth”. The delivery of health care, health information, and health education using electronic communications technology when you and the provider are in different locations.
• “Provider”, a licensed health care professional in Row Telehealth’s provider network (LocumTele) who evaluates and treats you.
• “Services”. Row Telehealth’s website, mobile applications, patient dashboard, and related telehealth features.
• “Synchronous”, real-time, two-way interaction, such as live video.
• “Asynchronous” (store-and-forward). The secure transmission of your information (such as intake responses, photos, or messages) that your provider reviews at a later time.
• “PHI”. Protected health information, as defined under HIPAA.

2. Description of the Services

2.1 How care is delivered

Row Telehealth connects you with a Provider through secure video and asynchronous messaging. Depending on your needs and your Provider’s judgment, a visit may involve reviewing your intake information, live video discussion, secure messaging, review of photographs or documents you submit, and follow-up communications.

2.2 What a Provider may do

During or after a telehealth encounter, a Provider may evaluate your condition, discuss your history and symptoms, make a diagnosis where appropriate, recommend or provide a treatment plan, order laboratory or diagnostic testing, make referrals, and, where medically appropriate and lawful, issue a prescription to be filled by our pharmacy partner (Rush Pharmacy) or a pharmacy of your choice.

2.3 What telehealth is not

Telehealth is a method of delivering care. It is not a guarantee of any particular diagnosis, treatment, prescription, or outcome, and it is not a substitute for in-person care where in-person care is medically necessary.

3. Voluntary Consent to Care by Telehealth

You voluntarily consent to receive care through telehealth. You understand that:

• Your participation is voluntary and you may stop at any time
• Your Provider is a licensed professional acting within the scope of their license and independent professional judgment
• This Consent is in addition to, not a substitute for, any specific consent you provide for a particular test, treatment, procedure, or medication, and
• Your Provider may decline to proceed by telehealth and may direct you to in-person, urgent, or emergency care.

4. Benefits of Telehealth

• Access to care regardless of your distance from a provider, including if you have limited mobility or live in an underserved area
• Convenience, with less travel and shorter wait times and flexible scheduling
• Privacy and comfort of receiving care from a location you choose
• Continuity, through secure messaging and easy follow-up, and
• Timely evaluation and management of conditions suitable for remote care.

5. Risks and Limitations

5.1 Clinical risks

• Electronic information may be insufficient (for example, without an in-person physical examination or hands-on testing) for a complete assessment or the most appropriate clinical decision.
• A condition may be missed, misdiagnosed, or under-treated, and treatment recommendations may be based on incomplete information.
• Incomplete medical history increases the risk of adverse events, including drug interactions or allergic reactions.
• Telehealth is not appropriate for all conditions or all patients.

5.2 Technology risks

• Poor connectivity, or hardware, software, power, or internet failures, may delay, interrupt, degrade, or prevent your visit.
• The quality of transmitted images or audio/video may affect your Provider’s assessment.

5.3 Security and privacy risks

• Despite reasonable safeguards, electronic transmission and storage carry a small risk that security measures could fail and that information could be intercepted or accessed by unauthorized persons.

5.4 Logistical risks

• Delays in evaluation, treatment, or prescription fulfillment may occur due to provider availability, technical issues, or pharmacy or laboratory processing.

6. Alternatives to Telehealth

You may instead seek an in-person appointment with a local provider, visit an urgent care center, or, in an emergency, go to the nearest emergency room. You may choose any alternative at any time. Declining telehealth will not affect your ability to obtain care elsewhere.

7. Prescriptions, Laboratory, and Follow-Up Care

7.1 Prescriptions

Any prescription is issued solely in your Provider’s professional judgment and is never guaranteed. Your Provider will not prescribe any medication they determine is unsafe, medically unnecessary, or inappropriate for telehealth.

7.2 Controlled substances

Controlled-substance prescribing is limited and occurs only where permitted by applicable federal and state law, including the Ryan Haight Act and applicable Drug Enforcement Administration telemedicine rules.

7.3 Pharmacy

If a medication is prescribed, it may be sent to our pharmacy partner (Rush Pharmacy) or a pharmacy you designate. Pharmacies are independent and maintain their own privacy and operational practices.

7.4 Laboratory and diagnostics

Your Provider may order tests to be completed at an outside laboratory or facility. You are responsible for completing ordered testing and for any associated costs not otherwise covered.

7.5 Follow-up and continuity

You are responsible for attending recommended follow-up visits and for arranging in-person care, testing, or specialist referrals your Provider recommends.

8. No Guarantee of Outcome

The practice of medicine is not an exact science. No guarantee has been or can be made regarding the results of any evaluation, treatment, or prescription provided through telehealth.

9. Your Provider, Credentials, and Licensure

You will be notified of your treating Provider’s name, credentials, and state of licensure when your consultation is assigned and reviewed. You can view this information at any time in your Appointment Details on the patient dashboard. Your Provider is licensed in the state where you are located at the time of your visit and provides care within the scope of that license.

10. Where We Provide Services. Your Location

Row Telehealth offers the Services to patients located in 49 U.S. states. We do not currently serve California. Care may be provided only where your Provider is licensed and where you are physically located at the time of the visit. By proceeding, you confirm that the state on your registration reflects your actual physical location when receiving care, and you agree to update it if it changes. Providing an inaccurate location may prevent us from lawfully delivering care and may result in cancellation of your visit.

11. Your Rights

• In-person care. You may request or seek in-person care at any time. Declining telehealth will not affect future care.
• Withdraw consent. You may withdraw this Consent at any time, without penalty, by notifying us or your Provider. Withdrawal applies to future care and does not affect care already provided.
• Confidentiality. The same confidentiality protections that apply to in-person care apply to your telehealth visit. Your PHI is handled under HIPAA and our Privacy Policy and Notice of Privacy Practices.
• Information and questions. You may ask questions at any time and receive information about your condition and options in understandable terms.
• Access and amendment. You may access and request amendment of your medical records as provided by law.
• Complaints. You may raise a concern or complaint by contacting support@rowtelehealth.com, without fear of retaliation.

12. Your Responsibilities

You agree to:

• Provide accurate, current, and complete information about your identity, health history, medications, allergies, and symptoms
• Be in a private, safe, and appropriate location, with a working device and connection, during your visit
• Follow your Provider’s instructions and treatment plan
• Complete recommended follow-up, testing, and referrals
• Keep your contact and location information current, and
• Promptly seek in-person or emergency care if your condition changes or worsens.

13. Privacy and Security

We use reasonable administrative, physical, and technical safeguards to protect information transmitted and stored in connection with your visit, consistent with the HIPAA Security Rule. Your information is used and disclosed only as permitted or required by law and as described in our Privacy Policy and Notice of Privacy Practices. Ordinary email and text messages are not fully secure. Please use the secure patient portal for health information.

14. Recording and Documentation

Your telehealth visit and related messages will be documented in your medical record. We may record video visits only where lawful and with any notice or consent required by applicable law. Any recording is part of your PHI. You agree not to record, photograph, or screen-capture any portion of your visit without your Provider’s knowledge and consent.

15. Consent to Electronic Communications

You consent to receive communications from us and your Provider electronically, including through the patient dashboard, secure messaging, email, and text/SMS, in connection with your care and account. Standard message and data rates may apply. Some care-related and transactional messages are necessary to provide the Services and cannot be opted out of while you use the Services.

16. Technology Requirements and Failure

Telehealth requires a compatible device, a supported browser or application, a camera and microphone for video visits, and a stable internet connection. If your consultation is interrupted or cannot be completed for technical reasons, contact support@rowtelehealth.com to reschedule or continue your visit. In a medical emergency, call 911.

17. Emergencies. Telehealth Is Not for Emergencies

Telehealth is not designed for emergencies. If you are experiencing a medical emergency, or believe you may be, call 911 or go to the nearest emergency room immediately. If you are having thoughts of harming yourself or others, call or text 988 (the Suicide and Crisis Lifeline). Your Provider cannot dispatch emergency responders and may not be immediately available.

18. Audio-Only Services

We currently offer video consultations only. If audio-only service is added in the future, it will require separate consent before it is used.

19. Accessibility and Language Access

If you need a reasonable accommodation or language-assistance services to participate in a visit, contact support@rowtelehealth.com in advance so we can arrange appropriate support.

20. Consent for Minors and Authorized Representatives

Our Services are intended for adults 18 and older. If care is provided to a minor or to a patient who cannot consent for themselves, the parent, legal guardian, or authorized representative establishing and managing the account represents that they are legally authorized to consent to the patient’s care and agrees to this Consent on the patient’s behalf, as permitted by applicable state law.

21. Financial Responsibility

You are responsible for the fees for the Services as disclosed to you, including amounts not covered by insurance and any pharmacy or laboratory charges. Consenting to telehealth does not waive your financial responsibility for care provided.

22. Changes to This Consent

We may update this Consent from time to time. The version number and dates above indicate the current version. Material changes will be presented for your acknowledgment before they apply to your care.

23. Contact Us

Rely Telehealth Plus, Inc. d/b/a Row Telehealth Support: support@rowtelehealth.com