Telehealth Informed Consent

Telehealth means delivering healthcare services remotely using technology, such as live video, audio, and secure electronic messaging, instead of meeting in person. It can be used for consultations, evaluation, diagnosis, treatment planning, prescribing, lab review, and ongoing follow-up care.

All clinical care at Optimal State Health is provided directly by Dr. Ahmad Ibrahim, DO, a board-certified physician licensed in California. Care is delivered through:

• Live video visits for consultations and follow-ups
• Secure messaging through our HIPAA-compliant patient portal (CharmHealth)
• Electronic lab orders and review of your lab results
• Electronic prescriptions sent to a pharmacy

If a video connection fails, a visit may be continued by phone when clinically appropriate, or rescheduled.

• Access to care from home, without travel or waiting rooms
• More flexible scheduling
• Continuity of care with the same physician over time
• Easier follow-up and communication between visits

Telehealth has real benefits, but it also has limits you should understand:

• No in-person physical exam. Some conditions can only be fully assessed in person. If Dr. Ibrahim determines that you need an in-person exam, imaging, or other care, you will be referred to an appropriate provider.
• Technology problems. Poor video or audio quality, dropped connections, or equipment failure may delay or interrupt care.
• Incomplete information. Decisions depend on the accuracy and completeness of the information you share. Missing or inaccurate information may affect your care.
• Security risks. Although we use secure, HIPAA-compliant systems, no electronic system is completely free of security risks.
• Treatment may not be appropriate. Telehealth may not be suitable for every condition, and some treatments may not be prescribed through telehealth.

Telehealth is your choice. You may instead seek in-person care from another provider at any time. Choosing not to use telehealth will not affect your right to receive care elsewhere. Because Optimal State Health is a telehealth-only practice, declining telehealth means we will not be able to provide your care, but we can help point you toward in-person options.

Dr. Ibrahim is licensed to practice in California. You must be physically located in California during every visit. You agree to confirm your location at the start of each visit when asked. If you are outside California, the visit will need to be rescheduled.

Telehealth through Optimal State Health is not for emergencies. If you have a medical emergency, such as chest pain, trouble breathing, signs of stroke, a severe allergic reaction, or thoughts of harming yourself, call 911 or go to the nearest emergency room.

For urgent concerns that are not emergencies, contact your local urgent care or primary care provider. Do not rely on portal messages for time-sensitive issues.

You can message Dr. Ibrahim directly through the patient portal. We aim to respond the same day during business hours. Messages sent in the evening, on weekends, or on holidays may be answered the next business day. Some questions may require a video visit rather than a message reply.

• Prescriptions are issued only when clinically appropriate, based on Dr. Ibrahim’s independent judgment. A visit does not guarantee a prescription.
• Some medications, including testosterone, are controlled substances and are prescribed in accordance with state and federal law. Additional requirements, such as lab monitoring or an in-person evaluation, may apply.
• Some medications may be compounded by state-licensed pharmacies. Compounded medications are not FDA-approved. Some uses may be off-label. These will be discussed with you before you start.
• Safe treatment depends on lab monitoring. You may be asked to complete labs at a local lab before starting and at regular intervals afterward.

Your telehealth visits and messages are protected by the same privacy laws that apply to in-person care, including HIPAA and the California Confidentiality of Medical Information Act. Your information is handled as described in our Notice of Privacy Practices and Privacy Policy.

For your own privacy, we recommend joining visits from a private location and using a personal, secure device and internet connection.

As a telehealth patient, you have the right to:

• Ask questions about telehealth and your care at any time
• Withdraw your consent to telehealth at any time, without affecting your right to future care elsewhere
• Access your medical records, including records of telehealth visits
• Request an in-person referral if you feel telehealth is not meeting your needs
• Have your information kept confidential as required by law

You agree to:

• Provide accurate, complete health information and tell us about all medications and supplements you take
• Confirm your identity and location when asked
• Join visits from a private place with a working camera, microphone, and internet connection
• Complete recommended labs and follow-up visits
• Seek emergency care when needed instead of waiting for a telehealth response

By signing this consent in our patient portal, or by giving verbal consent that is documented in your medical record, you confirm that:

• You have read and understand this information about telehealth
• You have had the opportunity to ask questions and have them answered
• You understand the benefits, risks, limitations, and alternatives described above
• You voluntarily consent to receive care through telehealth from Optimal State Health

This consent remains in effect for your care with us until you withdraw it. You may withdraw consent at any time by emailing support@optimalstatehealth.com. See also our Terms of Service.

If you have questions about this consent or about telehealth care, contact us at support@optimalstatehealth.com.

Optimal State Health · Dr. Ahmad Ibrahim, DO · California