LEGAL
Telehealth Informed Consent
Effective Date: July 14, 2026 · Entity: Roviran LLC, Wyoming · Website: roviran.com
Not for emergencies. If you are experiencing a medical emergency, call 911 immediately. In a mental health crisis, call or text 988.
1. What Telehealth Is
Telehealth is the delivery of clinical care using electronic information and communication technology, where the patient and the treating clinician are in different physical locations. A telehealth encounter may include the exchange of medical intake information, real-time audio and video consultation, the issuance of a prescription where clinically appropriate, and follow-up communication through secure messaging. This Consent explains the ways clinical care is delivered through the Roviran platform, the expected benefits and potential risks, and your rights and responsibilities as a patient. By checking the acceptance box during enrollment, you confirm that you have read and agreed to this Consent.
2. Parties to This Consent
Roviran LLC is a management services organization that coordinates non-clinical administrative, technology, and support services. Roviran does not provide medical services and is not a party to the clinician-patient relationship. Clinical services are delivered by an independently licensed professional entity (the “Provider Group”) and the individually licensed clinicians it employs or engages. Medications prescribed through the platform are dispensed by independently licensed pharmacies. Each Provider will be licensed in the state in which you are located at the time of the consultation.
3. Electronic Transmissions Used in Your Care
The following may occur during your care: account creation and scheduling; completion and review of medical intake forms; secure transmission of photographs, video, and laboratory results; synchronous and asynchronous consultations with your Provider; issuance of treatment plans and prescriptions where clinically appropriate; prescription refill reminders and clinical check-ins; and other transmissions reasonably necessary for your care.
4. Expected Benefits
Improved access to care from your home or preferred location. Convenient follow-up through secure messaging. More efficient evaluation and care management for conditions appropriately addressed by telehealth. Reduced time and cost associated with travel to in-person appointments.
5. Potential Risks and Limitations
No physical examination — the Provider cannot physically examine you; some conditions require in-person care. Technology failure — internet interruptions may delay or prevent a consultation. Image or data quality — if transmitted information is inadequate, your Provider may recommend in-person care. Security — no electronic system is fully immune to unauthorized access. Not for emergencies — if you are experiencing an emergency, call 911 immediately. Local primary care remains important — telehealth is a supplement to, not a substitute for, a primary care provider.
6. Patient Acknowledgments
By consenting to telehealth care, you acknowledge: I will be connected to a Provider licensed in my state. If I have a medical emergency I will call 911. I may decline telehealth at any time. I have the right to withhold or withdraw consent at any time. Federal and state laws protect the confidentiality of my health information. My health information may be transmitted to other licensed clinicians involved in my care. My personally identifiable information will not be shared with researchers without my separate consent. I accept the risk of technology failure and release the Provider and Roviran from liability for delays attributable to such failures to the fullest extent permitted by law. My Provider will explain any diagnosis and treatment options before I decide to proceed. There is no guarantee that I will be issued a prescription — this is the Provider’s independent clinical determination. I may request my medical records by emailing info@roviran.com.
7. Not for Emergencies
The Roviran platform does not furnish emergency medical services. If you are experiencing a medical emergency — including severe chest pain, difficulty breathing, signs of stroke, severe allergic reaction, or suicidal thoughts — call 911 or go to the nearest emergency department immediately. In a mental health crisis, call or text 988.
8. Financial Disclosures and the Federal Open Payments Program
The federal Physician Payments Sunshine Act requires certain manufacturers and group purchasing organizations to report payments made to physicians and teaching hospitals. This information is publicly searchable at openpaymentsdata.cms.gov. This disclosure is for informational purposes only and does not establish any conflict of interest or improper conduct by your Provider.
9. Withdrawal of Consent
You may withdraw your consent to telehealth at any time by notifying your Provider through secure messaging or by emailing info@roviran.com. Withdrawal of consent does not affect care already provided and does not cancel any scheduled shipment or recurring membership.
10. State-Specific Disclosures
Alaska: Residents have the right to receive copies of their telehealth encounter records. Complaints may be filed with the Alaska Division of Corporations, Business and Professional Licensing. Connecticut: Residents have the right to share copies of their telehealth records with their primary care physician. Florida: Residents are entitled to protections under Florida Statutes § 381.026. Iowa: Complaints may be filed with the Iowa Board of Medicine. Idaho: Complaints may be filed with the Idaho Board of Medicine. Indiana: Complaints may be filed with the Indiana Professional Licensing Agency. Kansas: A report of the telemedicine encounter will be sent to a designated primary care physician within three (3) days of patient consent. Kentucky: Complaints may be filed with the Kentucky Board of Medical Licensure. Maine: Complaints about M.D. clinicians may be filed with the Maine Board of Licensure in Medicine; D.O. clinicians with the Maine Board of Osteopathic Licensure. New Hampshire: Residents have the right to receive copies of their telehealth encounter records. Ohio: Residents have the right to share copies of their telehealth encounter records with their primary care physician. Oklahoma: Complaints about M.D. clinicians may be filed with the Oklahoma State Board of Medical Licensure and Supervision; D.O. clinicians with the Oklahoma State Board of Osteopathic Examiners. Rhode Island: Complaints may be filed with the Rhode Island Department of Health. South Carolina: Residents have the right to control the distribution of their medical records. Texas: With your consent, records may be transmitted to your primary care physician within 72 hours. Complaints may be reported to the Texas Medical Board, 333 Guadalupe, Tower 3, Suite 610, Austin, Texas 78768. Telephone: 1-800-201-9353. Vermont: Residents have the right to receive a real-time consultation with the distant-site provider (Vt. Stat. Ann. § 9361). Complaints may be filed with the Vermont Board of Medical Practice.
11. Acknowledgment
By checking the acceptance box at enrollment and proceeding to a consultation, you acknowledge that you have read this Telehealth Informed Consent, that you have had the opportunity to ask questions, and that you voluntarily consent to receive care via telehealth on the terms described above. A copy of this Consent is available at roviran.com and upon request to info@roviran.com.