Effective Date: February 18, 2026
The Shape Theory NP provides telehealth services using secure electronic communication platforms.
By scheduling services, you acknowledge and agree to the following:
1. Nature of Telehealth Services
Telehealth involves the use of digital communication technologies, including video conferencing, secure messaging, and electronic transmission of medical information.
Potential risks include:
- Technical failures or interruptions
- Limited ability to perform physical examination
- Reliance on patient-provided information
- Unauthorized access despite safeguards
Telehealth may not be appropriate for all conditions.
2. Provider Licensure & Location Verification
Telehealth services are provided only to patients physically located in states where the provider holds an active license at the time of the consultation.
Patients are responsible for truthfully disclosing their physical location at each appointment.
3. Not for Emergency Use
Telehealth services are not a substitute for emergency care.
If you experience:
- Chest pain
- Shortness of breath
- Severe abdominal pain
- Severe allergic reaction
- Symptoms of stroke
- Any medical emergency
Call 911 or seek immediate in-person medical care.
4. Electronic Communications
The Practice may use electronic communication methods including:
- Secure patient portals
- Text (SMS) messaging
- Appointment reminders
Electronic communications are used for convenience and care coordination.
5. Risks of SMS & Email Communication
Standard SMS text messaging and unencrypted email may carry privacy risks.
While reasonable safeguards are used, complete confidentiality cannot be guaranteed when communicating via:
- Standard text message
- Standard email platforms
Patients may opt to limit electronic communication methods if preferred.
6. Consent to Communication
By providing your phone number or email, you consent to receiving:
- Appointment reminders
- Follow-up instructions
- Treatment-related communication
- Administrative notifications
Message and data rates may apply depending on your carrier.
7. Revocation of Consent
You may withdraw consent for electronic communication at any time by contacting the Practice in writing.
However, this may limit certain conveniences of care.
8. Acknowledgment
By using our telehealth services, you acknowledge that:
- You understand the limitations of telemedicine
- You understand the risks of electronic communication
- You consent to receive care through telehealth technologies
The Shape Theory NP
info@theshapetheorynp.com