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MEDICAL HISTORY

Medical History Terms & Conditions
1. Consent to Treat and Privacy Policy
Center for Optimal Repair + Recovery (CORR LLC: “CORR”)

I consent to services and treatments provided by CORR, including its providers, employees, and affiliates. I have the right to refuse any suggested treatment, ask questions, and withdraw consent at any time. CORR providers will treat me within their scope of practice and may refer me to outside specialists if necessary. CORR offers treatments that may fall outside conventional medicine, including lab testing, medical imaging, IV therapy, injections, herbal medicine, hormone replacement, light therapy, cryotherapy, hyperbaric oxygen therapy, manual therapy, and nutritional therapy. Some therapies and approaches may involve off-label use of FDA-approved treatments or treatments not FDA-approved. I understand these are used based on clinical judgment, available research, and their potential benefits, and I have the right to decline such therapies. I acknowledge that even gentle therapies may involve risks, including adverse effects, temporary discomfort, or exacerbation of symptoms, and I will disclose all medical conditions, allergies, and medications to reduce these risks. CORR adheres to HIPAA and state privacy laws, and my personal and medical information will be used for treatment, coordination of care, and billing purposes, and may only be shared as required by law or for authorized care. I accept responsibility for costs associated with treatments, including those not covered by insurance. CORR does not provide emergency care, and I will call 911 or seek immediate assistance in an emergency. By signing or agreeing electronically, I confirm that I understand and consent to the treatments, disclosures, and policies described above.

Acknowledgment and Consent
By checking the box above, you acknowledge that you have read and understood this Consent to Treat and Privacy Policy, and you voluntarily agree to participate in services provided by CORR: Center for Optimal Repair + Recovery.

2. Telehealth Informed Consent
CORR: Center for Optimal Repair + Recovery
Introduction
Telehealth services allow patients to consult with healthcare providers remotely using secure, HIPAA-compliant technology. By agreeing to this consent, you acknowledge that you understand the benefits, limitations, and potential risks associated with telehealth services provided by CORR: Center for Optimal Repair + Recovery.

Nature of Telehealth Services
Telehealth involves the use of electronic communications to provide healthcare services, including but not limited to:
Consultations, evaluations, and follow-ups.
Diagnosis, treatment recommendations, and care plans.
Education and guidance on health conditions.

Benefits of Telehealth
Convenient access to healthcare services from any location.
Reduction in travel time and associated costs.
Ability to consult with providers more quickly.

Limitations of Telehealth
While telehealth is a valuable tool, it may have certain limitations, including:
Potential for technical issues (e.g., poor internet connection).
Inability to conduct physical examinations in person, which may limit diagnostic accuracy.
Possible need for in-person follow-up care for specific conditions.

Confidentiality and Privacy
CORR uses secure, HIPAA-compliant platforms to ensure your personal health information is protected.
You are responsible for ensuring a private location during telehealth sessions to maintain confidentiality.

Potential Risks
By using telehealth services, you acknowledge the following potential risks:
Unauthorized access to information due to security breaches (though unlikely).
Delays in care due to technical difficulties.
Miscommunication due to technology limitations or lack of physical examination.

Patient Responsibilities
Provide accurate and complete medical history and information.
Ensure access to reliable technology (e.g., internet, camera, microphone).
Follow provider recommendations, including any suggested in-person visits.

Consent to Telehealth Services
By providing your consent, you acknowledge and agree that:
Telehealth is appropriate for your healthcare needs at this time.
You understand and accept the limitations and risks of telehealth.
You have the right to withhold or withdraw consent at any time without affecting your access to future care.
8. Emergency Situations
Telehealth services are not suitable for medical emergencies. If you experience a medical emergency, please call 911 or go to the nearest emergency facility immediately.

Financial Responsibility
You understand that you are responsible for the costs associated with telehealth services as determined by CORR’s fee schedule and your insurance provider, if applicable.

Acknowledgment and Consent
By checking the box above, you acknowledge that you have read and understood this Telehealth Informed Consent, and you voluntarily agree to participate in telehealth services provided by CORR: Center for Optimal Repair + Recovery.
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