2. Telehealth Consent Form Root Cause Nurse – Virtual Wellness Services via Google Meet Purpose of Telehealth You are consenting to receive wellness education services through telehealth platforms (specifically Google Meet), which allows for HIPAA-conscious virtual care with a Registered Nurse (RN) licensed in Florida. What Telehealth Includes Live video meetings to review labs, discuss wellness strategies, and provide education Screen sharing for visual learning Email or secure messaging follow-up as needed No physical examination or emergency care is provided through this platform Benefits Convenient access from your home Real-time educational support Secure review of lab data, lifestyle goals, and supplement planning Risks & Limitations Technology can fail (e.g., dropped connections or poor video quality) Sensitive information may be exposed if your device isn’t secure Telehealth may not be appropriate for urgent or acute health concerns Responsibilities Ensure a private, quiet, and stable internet-connected environment Keep your software updated and use a secure device You are responsible for confirming all recommendations with your primary care provider Consent to Telehealth Services By signing below, I confirm that: I understand the purpose, benefits, and risks of telehealth services I agree to receive nurse-led wellness education virtually via Google Meet I understand this is not medical treatment or a substitute for licensed healthcare Digital Signature Clause: By digitally signing this form, you agree that your electronic signature is the legal equivalent of your manual signature on a paper document.*