Customer Consent to Receive Virtual Care and Communicaiton

Health Consent to Use Virtual Care Tools and Electronic Communications

I acknowledge that I have read and fully understand the risks, limitations, conditions of use, and instructions for use of the selected electronic communication and storage services, including, as applicable: the Prescrypt Inc. virtual care web app, email (unencrypted or encrypted), video conferencing tools (unencrypted or encrypted) and other electronic communications (collectively, the “Prescrypt Customers Platform”) more fully described in this notice and in Prescrypt’s Terms of Use and Privacy Policy to communicate and store my personal information (including information about my health, symptoms, diagnoses, test results and treatment plans). I understand and accept the risks outlined in this notice associated with the use of the Prescrypt Customers Platform and electronic communications with Prescrypt physicians and nurse practitioners, and other healthcare professionals (each, an “Authorized Healthcare Professional”) I consent to the conditions and will follow the instructions outlined in this notice, as well as any other conditions that the Authorized Healthcare Professional may impose in relation to patients using the Prescrypt Customers Platform.

I acknowledge and understand that despite recommendations that encryption software be used as a security mechanism when communicating via email, if I choose to email an Authorized Healthcare Professional or otherwise request that an Authorized Healthcare Professional interact with me over email, the Authorized Healthcare Professional may respond to me over unencrypted email (which may include my sensitive health information). Use of unencrypted technologies heightens the risks associated with the use of virtual care tools and electronic communication (as outlined in more detail below).

I acknowledge that either I or the Authorized Healthcare Professional may, at any time, withdraw the option of communicating electronically through the Prescrypt Customers Platform by closing my account, leaving the consultation or otherwise providing written notice.

Any questions I had have been answered. If I have any further questions or concerns at any point regarding the handling or storage of my personal information on the Prescrypt Customers Platform, I understand that I can review Prescrypt’s Privacy Policy and/or reach out to the Prescrypt Privacy Officer, Emma Stern at privacy[ at ] prescrypt [ dot ] ca at any time.

I acknowledge that if I choose to receive my prescription from a Prescrypt pharmacy that this prescription may be dispensed from Prescrypt Pharmacy Inc., a pharmacy located in Vaughan, Ontario.

Risks of using virtual care tools and electronic communication

The Authorized Healthcare Professional will use reasonable means to protect the security and confidentiality of information sent and received using the Prescrypt Customers Platform. However, because of the risks outlined below, the Authorized Healthcare Professional cannot guarantee the security and confidentiality of information sent and received using the Prescrypt Customers Platform:

Use of electronic communications to discuss sensitive information can increase the risk of such information being disclosed to third parties.
Despite reasonable efforts to protect the privacy and security of information communicated through the Prescrypt Customers Platform, it is not possible to guarantee complete security of all information
Employers and online services may have a legal right to inspect and keep electronic communications that pass through their system.
Electronic communications can introduce malware into a computer system, and potentially damage or disrupt the computer, networks, and security settings.
Electronic communications (particularly those that are unencrypted) can be misdirected, forwarded, intercepted, lost, circulated, stored, or even altered or changed without the knowledge or permission of the Authorized Healthcare Professional or the patient.
Even after the sender and recipient have deleted copies of electronic communications, backup copies may exist on a computer system.
Electronic communications may be disclosed in accordance with a duty to report or a court order.
Some video conferencing platforms may be more open to interception than other forms of video conferencing.

If you choose to communicate with the Authorized Healthcare Professional over email (unencrypted or encrypted), you should be aware of the following additional risks:

Email can more easily be misdirected or intercepted, resulting in increased risk of being received, accessed or viewed by unintended or unknown recipients. This risk is increased when using unencrypted technologies.
Email can be easier to falsify than handwritten or signed hard copies. It is not feasible to verify the true identity of the sender, or to ensure that only the recipient can read the message once it has been sent.

Conditions of Using the Prescrypt Customers Platform

While the Authorized Healthcare Professional will attempt to review and respond in a timely fashion to your electronic communications, the Authorized Healthcare Professional cannot guarantee that all electronic communications will be reviewed and responded to within any specific period of time. The Prescrypt Customers Platform is not to be used for medical emergencies or other time-sensitive matters.
If your electronic communication requires or invites a response from the Authorized Healthcare Professional and you have not received a response within a reasonable time period, it is your responsibility to follow up to determine whether the intended recipient received the electronic communication and when the recipient will respond.
Electronic communication is not an appropriate substitute for in-person or over-the-telephone communication or clinical examinations, where appropriate, or for attending the Emergency Department when needed. You are responsible for following up on the Authorized Healthcare Professional’s electronic communication and for scheduling appointments where warranted.
Electronic communications concerning diagnosis or treatment may be printed or transcribed in full and made part of your medical record. Other individuals authorized to access the medical record, such as staff and billing personnel, may have access to those communications.
The Authorized Healthcare Professional may forward electronic communications to staff and those involved in the delivery and administration of your care. The Authorized Healthcare Professional will not forward electronic communications to third parties, including family members, without your prior written consent, except as authorized or required by law.
You agree to inform the Authorized Healthcare Professional of any types of information you do not want sent via the Prescrypt Customers Platform.
Certain functionalities in the Prescrypt Customers Platform might not be used for therapeutic purposes or to communicate clinical information. Where applicable, the use of these functionalities will be limited to education, information, and administrative purposes.
The Authorized Healthcare Professional is not responsible for information loss due to technical failures associated with the software or your internet service provider.

Instructions for communication using the Prescrypt Customers Platform

When communicating through the Prescrypt Customers Platform, you must:

Reasonably limit or avoid using an employer’s or other third party’s computer.
Conduct virtual care encounters in a private setting and using a secure device, where possible.
Obtain the Authorized Healthcare Professional’s consent prior to making any recording of the virtual encounter.
Inform the Authorized Healthcare Professional of any changes in your email address, mobile phone number, or other account information necessary to communicate via the Prescrypt Customers Platform.
If you require immediate assistance, or if your condition appears serious or rapidly worsens, you should not rely on the Prescrypt Customers Platform. Rather, you should call a physician’s office or take other measures as appropriate, such as calling 911 or going to the nearest Emergency Department or urgent care clinic.

If you choose to communicate with the Authorized Healthcare Professional over email (unencrypted or encrypted), the following also applies:

Include in the message’s subject line an appropriate description of the nature of the communication (e.g., “prescription renewal”), and your full name in the body of the message.
Review all electronic communications to ensure they are clear and that all relevant information is provided before sending to the Authorized Healthcare Professional.
Ensure the Authorized Healthcare Professional is aware when you receive an electronic communication from the Authorized Healthcare Professional, such as by a reply message or allowing “read receipts” to be sent.
Take precautions to preserve the confidentiality of electronic communications, such as by using screen savers and safeguarding computer passwords.
Withdraw consent only by email or other written communication to the Authorized Healthcare Professional.
If you require immediate assistance, or if your condition appears serious or rapidly worsens, you should not reply through the Prescrypt Customers Platform. Rather, you should take other measures as appropriate, such as calling 911 or going to the nearest Emergency Department or urgent care clinic.

Nature and Scope of Healthcare Services

Prescrypt healthcare services are only available to individuals located in Alberta, British Columbia, Manitoba, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, or Saskatchewan. As the rules regarding telehealth may differ among the provinces Prescrypt operates in, the healthcare services that are available to you will depend on your province of residence and the location you are in at the time you request the services.
You recognize that the Authorized Healthcare Professionals providing healthcare services on the Prescrypt Customers Platform do not have access to your full and complete medical record and are unable to physically examine you. By virtue of this limitation, they are relying on you to provide an accurate and honest description of your medical history, and report certain physical parameters when requested.

As with any other healthcare consultation, no results can be guaranteed or assured in connection with healthcare services. Your Authorized Healthcare Professional may determine healthcare services are not appropriate for some or all of your treatment needs or that he or she is not permitted to provide the services you require and may elect not to provide healthcare services to you. Authorized Healthcare Professionals also have the discretion to discontinue the provision of healthcare services to you at any time and for any reason.
The following symptoms are NOT eligible to be treated through the healthcare services: chest pains; difficulty breathing; fever in children under the age of 3 months; blackouts or feeling like you may blackout; any impairment in level of consciousness; stroke-like symptoms such as impaired sensation or paralysis to one side of your body; inability to speak or comprehend language; any abdominal pain severe enough that you are unable to comfortably walk.
The Prescrypt Customers Platform cannot be used for emergency healthcare. If you believe that you are dealing with an emergency, you will call 911 immediately or attend your nearest Emergency Department or urgent care clinic. You agree that you will seek emergency help or follow-up care when recommended by an Authorized Healthcare Professional.
Any prescriptions you acquire from an Authorized Healthcare Professional are solely for the personal use of the individual named on the prescription. You will fully and carefully read all provided product information and labels, and contact a licensed healthcare professional such as a physician, nurse practitioner, or pharmacist, if you have any questions regarding the prescription or medication.

For additional information, please refer to the Prescrypt Terms of Service.

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Prescrypt Pharmacy Consent to Use Virtual Care Tools and Electronic Communications

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I understand and accept the risks outlined in this notice associated with the selection of the Prescrypt Pharmacy Network and electronic communications with Authorized Healthcare Professionals and/or Prescrypt Agents to receive Pharmacy Services. I consent to the conditions and will follow the instructions outlined in this notice, as well as any other conditions that the Authorized Healthcare Professional may impose in relation to patients using the Prescrypt Customers Platform and/or the Prescrypt Pharmacy Network .

I acknowledge and understand that despite recommendations that encryption software be used as a security mechanism when communicating via email, if I request that an Authorized Healthcare Professional or Prescrypt Agent interact with me over email, they may respond to me over unencrypted email (which may include my sensitive health information). Use of unencrypted technologies heightens the risks associated with the use of Virtual Care Tools and electronic communication.

I acknowledge that either I, or the Authorized Healthcare Professional may, at any time, withdraw the option of communicating electronically by providing written notice.

Any questions I had have been answered. If I have any further questions or concerns at any point regarding the handling or storage of my Personal Information within the Prescrypt Customers Platform or the Prescrypt Pharmacy Network I understand that I can review Prescrypt’s Privacy Policy and/or reach out to the Prescrypt Privacy Officer, Emma Stern at privacy[ at ] prescrypt [ dot ] ca at any time.

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Definitions

Authorized Healthcare Professionals - Pharmacists and Pharmacy Technicians licensed to practice medicine in a province or territory of Canada

Electronic Communications - Communication sent by any means of telecommunication, including a text, sound, voice or image message (unencrypted or encrypted)

‍Prescrypt Agents - Includes all of its officers, administrators, and employees of Prescrypt and the Prescrypt Pharmacy Network who support the provision of Pharmacy Services

Prescrypt Customers Platform - Collectively, the hardware, software, websites, content, products and services owned and/or operated by us to enable the provision of remote healthcare services to Users, among other purposes

Prescrypt Pharmacy Network - Collectively, the hardware, software, products and services owned and/or operated by Prescrypt Pharmacy partners

Personal Information - Collectively “Personal Information” (information about an identifiable User as defined by the Applicable Law) and “Personal Health Information” or “PHI” (information about a User’s health or healthcare as defined in the Applicable Law)

Pharmacy Services - Any professional services provided by or on behalf of a Pharmacist or Pharmacy Technician including, but not limited to, patient-pharmacist consultation, refill management, and medication delivery via registered mail

User - (Hereinafter “you”, “your”) An individual registered to use the Prescrypt Customers Platform who has selected a Prescrypt Pharmacy Network to receive Pharmacy Services

Virtual Care - Any interaction between Users and Authorized Healthcare Professionals that includes the provision of a professional service and occurs remotely using Virtual Care Tools

Virtual Care Tools - Any technology that permits communication between individuals in different locations, including through teleconferencing, video conferencing, email, or other internet-hosted services or applications

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Risks of Using Virtual Care Tools and Electronic Communication

The Authorized Healthcare Professional will use reasonable means to protect the security and confidentiality of information sent and received via Virtual Care Tools. However, due of the risks outlined below, the Authorized Healthcare Professional cannot guarantee the security and confidentiality of information sent and received using Virtual Care Tools:

Use of Electronic Communications to discuss sensitive information can increase the risk of such information being disclosed to third parties
Despite reasonable efforts to protect the privacy and security of information communicated through the Prescrypt Pharmacy Network, it is not possible to guarantee complete security of all information
Employers and online services may have a legal right to inspect and keep Electronic Communications that pass through their system
Electronic Communications can introduce malware into a computer system, and potentially damage or disrupt the computer, networks, and security settings
Electronic Communications (particularly those that are unencrypted) can be misdirected, forwarded, intercepted, lost, circulated, stored, or even altered or changed without the knowledge or permission of the Authorized Healthcare Professional or the patient
Even after the sender and recipient have deleted copies of Electronic Communications, backup copies may exist on a computer system
Electronic communications may be disclosed in accordance with a duty to report or a court order

If you choose to communicate with the Authorized Healthcare Professional or Prescrypt Agent over email (unencrypted or encrypted), you should be aware of the following additional risks:

Email can more easily be misdirected or intercepted, resulting in increased risk of being received, accessed or viewed by unintended or unknown recipients. This risk is increased when using unencrypted technologies.
Email can be easier to falsify than handwritten or signed hard copies. It is not feasible to verify the true identity of the sender, or to ensure that only the recipient can read the message once it has been sent.

Conditions of Receiving Virtual Care Pharmacy Services through the Prescrypt Pharmacy Network

While the Authorized Healthcare Professional and/or Prescrypt Agent will attempt to review and respond in a timely fashion to your electronic communications, there is no guarantee that all electronic communications will be reviewed and responded to within any specific period of time. The Prescrypt Customers Platform and Prescrypt Pharmacy Network is not to be used for medical emergencies or other time-sensitive matters.
If your electronic communication requires or invites a response from the Authorized Healthcare Professional and/or Prescrypt Agent and you have not received a response within a reasonable time period, it is your responsibility to follow up to determine whether the intended recipient received the electronic communication and when the recipient will respond.
Virtual Care and Electronic Communications are not appropriate substitutes for communication or clinical examinations, where appropriate, or for attending the Emergency Department when needed. You are responsible for following up on the Authorized Healthcare Professional’s electronic communication and for scheduling appointments where warranted.
The Authorized Healthcare Professional may forward Electronic Communications to Prescrypt Agents and any other third-party contractually involved in the delivery and administration of Pharmacy Services. The Authorized Healthcare Professional will not forward Electronic Communications to third parties who are not involved in the delivery and administration of Pharmacy Services, including family members, without your prior written consent, except as authorized or required by law.
You agree to inform the Authorized Healthcare Professional of any types of information you do not wish to include in your Prescrypt Pharmacy Network profile.
Certain functionalities associated with the Prescrypt Pharmacy Network might not be used for therapeutic purposes or to communicate clinical information. Where applicable, the use of these functionalities will be limited to education, information, and administrative purposes.
The Authorized Healthcare Professional is not responsible for information loss due to technical failures associated with the software or your internet service provider.

Instructions for Communication Regarding Virtual Care Pharmacy Services Being Administered through the Prescrypt Pharmacy Network

When communicating using Virtual Care Tools, you must:

Reasonably limit or avoid using an employer’s or other third party’s computer.
Conduct Virtual Care encounters in a private setting and using a secure device, where possible.
Obtain the Authorized Healthcare Professional’s consent prior to making any recording of the Virtual Care and/or Electronic Communication
Inform the Authorized Healthcare Professional of any changes in your email address, mobile phone number, or other account information necessary to receive Virtual Pharmacy Services
If you require immediate assistance, or if your condition appears serious or rapidly worsens, you should not rely on the Prescrypt Customers Platform or Prescrypt Pharmacy Network. Rather, you should call a physician’s office or take other measures as appropriate, such as calling 911 or going to the nearest Emergency Department or urgent care clinic.

If you are provided with the opportunity to communicate with the Authorized Healthcare Professional over email*, the following also applies:

Include in the message’s subject line an appropriate description of the nature of the communication (e.g., “prescription renewal”), and your full name in the body of the message.
Review all Electronic Communications to ensure they are clear and that only relevant information is provided before sending to the Authorized Healthcare Professional.
Ensure the Authorized Healthcare Professional is aware when you receive an Electronic Communication from the Authorized Healthcare Professional, such as by a reply message or allowing “read receipts” to be sent.
Take precautions to preserve the confidentiality of Electronic Communications, such as by using screen savers and safeguarding computer passwords.
Withdraw consent only by email or other written communication to the Authorized Healthcare Professional.
If you require immediate assistance, or if your condition appears serious or rapidly worsens, you should not reply through the Prescrypt Customers Platform. Rather, you should take other measures as appropriate, such as calling 911 or going to the nearest Emergency Department or urgent care clinic.

* The option to communicate via email with an Authorized Healthcare Professional within the Prescrypt Pharmacy Network will be limited to certain Pharmacy Services. This has been implemented in the interest of User privacy and confidentiality; if another form of communication is not available to you, please contact accessibility[ at ] prescrypt [ dot ] ca to request alternative accommodations.

Nature and Scope of Pharmacy Services

Prescrypt Pharmacy Network Pharmacy Services are only available to individuals located in Alberta, British Columbia, Manitoba, Newfoundland and Labrador, Nova Scotia, Ontario, Prince Edward Island, or Saskatchewan. As the rules regarding Virtual Care Pharmacy Services may differ among the provinces the Prescrypt Pharmacy Network operates in, the Pharmacy Services that are available to you will depend on your province of residence and the location you are in at the time you request the services.
You recognize that the Authorized Healthcare Professionals providing Pharmacy Services through the Prescrypt Pharmacy Network do not have access to your full and complete medical record and are unable to physically examine you. By virtue of this limitation, they are relying on you to provide an accurate and honest description of your medical history, and report certain physical parameters when requested.
As with any other Pharmacy Services, no results can be guaranteed or assured. Your Authorized Healthcare Professional may determine Pharmacy Services are not appropriate for some or all of your treatment needs or that he or she is not permitted to provide the services you require and may elect not to provide Pharmacy Services to you. Authorized Healthcare Professionals also have the discretion to discontinue the provision of Pharmacy Services to you at any time and for any reason.
The following symptoms are NOT eligible to be treated through the Pharmacy Services: chest pains; difficulty breathing; fever in children under the age of 3 months; blackouts or feeling like you may blackout; any impairment in level of consciousness; stroke-like symptoms such as impaired sensation or paralysis to one side of your body; inability to speak or comprehend language; any abdominal pain severe enough that you are unable to comfortably walk.
The Prescrypt Customers Platform and/or Prescrypt Pharmacy Network cannot be used for emergency healthcare. If you believe that you are dealing with an emergency, you will call 911 immediately or attend your nearest Emergency Department or urgent care clinic. You agree that you will seek emergency help or follow-up care when recommended by an Authorized Healthcare Professional.
Any medications dispensed under a prescription from an Authorized Healthcare Professional are solely for the personal use of the individual named on the prescription. You will fully and carefully read all provided product information and labels, and contact a licensed healthcare professional such as a physician, nurse practitioner, or pharmacist, if you have any questions regarding the prescription or medication.
For additional information, please refer to the Prescrypt Customer Terms of Use and Customer Privacy Policy