Effective Date: June 2026

Welcome to Vita Drip & Beauty Bar and Vita Weight Loss & Hormone Health. This Telemedicine Patient Agreement explains the terms and conditions governing telemedicine services provided through our practice. By scheduling an appointment, completing an intake form, participating in a telemedicine consultation, or purchasing services through our website, you acknowledge and agree to the terms below.

Telemedicine Services

Telemedicine allows healthcare services to be delivered remotely using secure electronic communications, including video conferencing, telephone calls, electronic forms, patient portals, and other approved technologies.

Services offered may include:

• Medical weight loss evaluations and management
• Hormone health consultations
• Wellness consultations
• Prescription management
• Follow-up visits
• Review of laboratory results
• Other healthcare services as determined appropriate by the provider

Provider Evaluation Required

All patients must undergo a medical evaluation by a licensed healthcare provider before treatment recommendations or prescriptions can be made.

Payment for a consultation or program does not guarantee:

• Approval for treatment
• Issuance of a prescription
• Eligibility for a specific medication
• Specific health outcomes or weight loss results

All treatment decisions are based on the provider’s medical judgment and applicable laws and regulations.

Patient Responsibilities

Patients agree to:

• Provide accurate and complete medical information
• Disclose all medications, supplements, allergies, and medical conditions
• Update the provider regarding any significant changes in health status
• Follow treatment recommendations and instructions
• Seek emergency medical care when necessary

Failure to provide accurate information may impact treatment decisions and patient safety.

Risks of Telemedicine

While telemedicine offers convenience and accessibility, there are limitations, including:

• Potential technical difficulties or interruptions
• Reduced ability to perform physical examinations
• Possible delays in evaluation due to technology issues
• Risks associated with electronic communication

Patients understand these limitations and consent to receiving care through telemedicine when appropriate.

Prescription Medications

Certain services may involve prescription medications.

Patients understand that:

• Prescription medications may cause side effects or adverse reactions.
• Results vary from person to person.
• No medication is guaranteed to be appropriate for every patient.
• The provider may discontinue treatment or require additional testing when medically necessary.

Patients should contact emergency services immediately if they experience a medical emergency.

Medical Weight Loss Programs

Medical weight loss treatments are designed to support healthy weight management when medically appropriate.

The practice does not guarantee:

• Any specific amount of weight loss
• A particular rate of weight loss
• Long-term maintenance of results

Individual outcomes depend on many factors, including adherence to treatment, nutrition, exercise, medical conditions, and lifestyle habits.

Laboratory Testing

The provider may require laboratory testing before initiating or continuing treatment.

Patients are responsible for obtaining requested laboratory work and ensuring results are provided when required.

Failure to complete requested testing may delay or prevent treatment.

Fees and Payments

Payment is required prior to consultation, treatment review, prescription processing, or medication ordering.

Fees may include:

• Consultation fees
• Follow-up visit fees
• Medication costs
• Laboratory fees
• Shipping and handling fees

All pricing is subject to change without notice.

Refund Policy

Consultation fees are non-refundable once a provider has reviewed a patient’s information or performed a medical evaluation.

Medication orders are generally non-refundable once prescribed, processed, compounded, shipped, or dispensed.

Exceptions may be made only when required by law or at the discretion of practice management.

Privacy and Confidentiality

The practice is committed to protecting patient information and maintaining compliance with applicable federal and state privacy laws, including HIPAA.

Patient information will only be shared as permitted by law or as necessary for treatment, payment, or healthcare operations.

Consent to Telemedicine

By using our services, the patient voluntarily consents to receive healthcare services through telemedicine technologies and understands the risks, benefits, and limitations associated with remote care.

Limitation of Liability

Healthcare outcomes cannot be guaranteed. The practice, its providers, employees, and affiliates shall not be liable for outcomes resulting from:

• Incomplete or inaccurate patient information
• Failure to follow medical advice
• Misuse of prescribed medications
• Technical failures beyond the practice’s control

Contact Information

Vita Drip & Beauty Bar
Vita Weight Loss & Hormone Health

Website: www.vitadripbeautybar.com

For medical emergencies, call 911 or seek immediate emergency medical care.

Acceptance of Agreement

By accessing this website, scheduling services, completing forms, participating in telemedicine consultations, or purchasing products or services, you acknowledge that you have read, understood, and agree to this Telemedicine Patient Agreement.