Patient Care

Telehealth Informed Consent

Last updated: June 24, 2026

This document explains how telehealth works at The Vitality & Aesthetics Institute, PLLC ("TVAAI"), including how prescriptions — such as weight-management (GLP-1), hormone, and other therapies — are evaluated, prescribed, and dispensed. Please read it carefully before your telehealth visit.

1. What telehealth is

Telehealth uses secure video, phone, and electronic messaging to deliver care when you and your provider are in different locations. It may be used for consultations, follow-ups, lab review, and ongoing monitoring of therapy. Some services require an in-person visit and cannot be completed by telehealth alone.

2. A valid evaluation is required before any prescription

No prescription is issued without an appropriate evaluation. Before prescribing, a licensed provider will review your medical history, current medications, relevant labs or vitals, and your goals, and will conduct a clinical evaluation sufficient to establish a legitimate provider–patient relationship under Texas law (a "good-faith examination"). We do not prescribe based on an online questionnaire alone. Your provider may decline to prescribe, or may require additional testing or an in-person visit, when that is clinically appropriate.

3. Prescriptions and compounded medications

Some therapies we offer use compounded medications — including, in certain cases, compounded semaglutide or tirzepatide. You should understand the following:

• Compounded medications are not FDA-approved and are not reviewed by the FDA for safety, effectiveness, or quality in the same way as commercially manufactured drugs.
• FDA-approved, commercially available alternatives may exist for your condition. Your provider will discuss those options with you.
• A compounded medication is prescribed only when your prescriber determines, and documents, a patient-specific clinical need — for example, an allergy or intolerance to an ingredient in the approved product, or a clinically required dose or formulation not commercially available. This determination is made individually for you, not as a standard substitution.
• Compounded medications are prepared by a separately licensed compounding pharmacy in accordance with applicable state and federal law.

4. How your medication is dispensed

TVAAI does not act as your pharmacy. Compounded medications are prepared and dispensed by Revive Rx (Revive Rx LLC dba Revive Rx Pharmacy), a state-licensed compounding pharmacy, and other independently licensed pharmacies where applicable. The pharmacy is responsible for preparing, labeling, and shipping or dispensing your medication.

5. Benefits and risks of telehealth

Benefits include improved access and convenience. Risks and limitations include the possibility that, without an in-person exam, a condition may not be fully assessed; that technology may fail or delay care; and that electronic transmission, although secured, carries some inherent privacy risk. If telehealth is not adequate for your needs, your provider will recommend in-person care.

6. Privacy and your records

Your telehealth information is part of your medical record and is protected under HIPAA and our Privacy Policy and Notice of Privacy Practices. We use secure, encrypted platforms for telehealth visits and messaging.

7. Emergencies

Telehealth is not for emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room.

8. Voluntary participation and right to withdraw

Your participation in telehealth is voluntary. You may withhold or withdraw consent at any time without affecting your right to future care, and you may request an in-person visit instead.

9. Acknowledgment and consent

By signing the executable version of this form, you confirm that you have read and understood this information, that you have had the opportunity to ask questions, and that you consent to receive care by telehealth on these terms, including the use of compounded medications where your provider determines they are appropriate for you.