Informed Consent for Telehealth Services

Effective date: August 3, 2026. By scheduling or participating in a telehealth visit with DJI Healthcare, doing business as Essential Health RX, you acknowledge that you have read, understood, and agree to the following.

1. What telehealth is

Telehealth is the delivery of medical care using electronic communications — video visits, phone calls, and secure messaging — when you and your physician are not in the same location. Your care at Essential Health RX is provided by Dan Inglish, DO, and may include synchronous (live video/phone) visits and asynchronous (secure messaging and questionnaire review) care where permitted by law.

2. Expected benefits

Easier and faster access to your physician, care without travel or waiting rooms, and more frequent communication about your health.

3. Possible risks

Telehealth has limitations. The physician cannot perform a hands-on physical examination, which, in rare cases, could affect the diagnosis. Technology can fail or be interrupted. Despite safeguards, electronic communications carry some security risk. If at any point your physician determines your condition requires in-person evaluation, you will be directed to appropriate in-person care.

4. Alternatives

You may seek in-person care from a physician, urgent care clinic, or other provider of your choice at any time. Telehealth is offered as a convenience, not a requirement.

5. Emergencies

Telehealth is not for emergencies. If you are experiencing a medical emergency, call 911 immediately.

6. Privacy and records

Your telehealth visits are confidential and protected under HIPAA and California law, as described in our Privacy Policy and our HIPAA Notice of Privacy Practices, available from our office on request. A medical record of your care is maintained just as with in-person care, and you have the right to access it. Visits are not recorded without your explicit consent.

7. Your rights and responsibilities

You may withhold or withdraw this consent at any time without affecting your right to future care. You agree to provide accurate and complete health information, to confirm your physical location at the start of each visit (services are available only in California), and to verify your identity with government-issued ID when requested. Prescriptions are issued only when the physician determines treatment is medically appropriate; payment for a visit or membership does not guarantee a prescription.

A copy of this consent is also presented for signature in your patient intake.