Legal
The lawyer stuff
DudeMeds LLC
TERMS AND CONDITIONS
Effective Date: January 1, 2024
THIS NOTICE DESCRIBES OUR TERMS AND CONDITIONS. PLEASE REVIEW IT CAREFULLY.
Introduction
The dudemeds.com website is owned and operated by DudeMeds LLC, a company incorporated in Florida, USA.
These Terms of Use affect your legal rights and obligations so please read them carefully. If you do not agree to be bound by these Terms of Use, do not use our website.
We’re at your disposal if you need any help or have any questions regarding our website. Simply send an email to [email protected] or use our Contact page.
We reserve the right to update these Terms of Use from time to time at our discretion. If we do so, the updated version will be effective as soon as it is accessible. You are responsible for regularly reviewing these Terms of Use so that you are aware of any changes to them.
Consent for treatment
I hereby authorize DudeMeds pharmacy partners to provide products, supplies and services as prescribed by my physician. I confirm I have been informed and have participated in planning my care and
sign this consent willingly and voluntarily. I understand this consent is valid from the date of the start of initial therapy and I may withdraw my consent at any time by notice to DudeMeds LLC and, if I do so, the services thereafter will not be provided, but some payments may remain and shall be due.
Consent for payment
I clearly understand and agree that all services rendered to me may be charged directly to me, and that I am personally responsible for full payment. I understand that even if I suspend or
terminate treatment, the fees to purchase the medication for the first three (3) months are due, and if paid are non-refundable.
Other applicable terms
You should familiarize yourself with our Privacy Policy, which also applies to your use of our Site and sets out the terms on which we handle the data we collect from you as well as the data you provide to us.
In purchasing anything from us (medicines or other products), you will need to refer to our Terms of Sale.
Access to our website
In certain cases, we reserve the right to restrict access to certain parts of our website.
Your account information (login address, password, or any other piece of identifiable information) is strictly confidential and should not be shared with any third party. We reserve the right to disable your access to this site if we have reason to believe you have failed to comply with the provisions of these terms.
Our website is for your personal use. You agree not to use our website or the content of our website for any commercial or business purposes.
You must not attempt to gain unauthorized access to our website, the server on which our website is hosted, or any server, computer or database connected to it. And of course, you’ll no longer be able to use our website.
We can’t accept responsibility for any damage or loss suffered because of a distributed denial-of-service attack, viruses, or other technologically harmful material that may infect your device, programs, data, or other proprietary material as a result of using our website, downloading any material posted on it, or using/downloading content from any website linked to it.
Acceptable Use
Any material which you contribute or upload to our Site must be true, accurate and correct, comply with applicable law and must not defame any person, be obscene, offensive, hateful or inflammatory, promote discrimination based on race, sex, religion, nationality, disability, sexual orientation or age, infringe any copyright, database right or trademark of any other person, be likely to deceive any person, breach any legal duty owed to a third party (such as a contractual duty or a duty of confidence), impersonate any person, or misrepresent your identity or affiliation with any person.
You shall not knowingly transmit any data that can be harmful to our website including, but not limited to, trojan horses, worms, time-bombs, keyloggers, spyware, and adware.
Linking to our website
We want to give everyone the tools to get the best healthcare, so the more people who know about us, the better. If you do want to tell your friends or family about DudeMeds, or link to our website, please follow the guidelines below:
- We’re proud of our reputation and will take whatever steps are necessary to protect it.
- Please do not suggest any form of association, approval, or endorsement by DudeMeds if none exists.
- Please make sure you only include a link (not a frame) to the homepage of our website. There are strict regulations on promoting medication, so you can only talk about ourselves as an online health platform. Please don’t mention specific medications.
- If you’re unsure, please ask us before linking to our website. We reserve the right to withdraw linking permission without notice if it doesn’t meet our guidelines.
Links on our website
We sometimes link to other websites and mobile apps. These links are there for your information only and we have no control over their content. We can’t guarantee they are factually correct, nor can we accept any responsibility for any damage or loss you may suffer as a result of their use.
Intellectual property rights
Everything that you see on our website is protected by copyright. DudeMeds is either the owner or the licensee of the material published and of all the attached rights. All such rights are reserved, which means use of our website content is limited:
- You can print off one copy, and download extracts of any page(s) of our website for your personal reference only, but not for commercial reasons (for this, you’ll need a license from us or our licensors).
- Please don’t modify the paper or digital copies of any materials you’ve printed off or downloaded in any way. You are unable to use illustrations, photographs, video or audio sequences or any graphics without using the text that goes with them. Please always reference DudeMeds or any other authors of materials on our website.
- If you are unable to meet these guidelines, we will ask you to stop using our website immediately and to either return or destroy any copies you’ve made of our materials.
Warranties
The content of the website may change, be updated or suspended. Therefore, we are unable to give you, and we exclude, all representations and warranties as to the accuracy and completeness of the information published on our website. Nor can we guarantee that the material is up to date or that every service and product will be available at all times, or indeed that the website itself will not be discontinued in the future.
We can’t be held liable and you will not be entitled to any type of compensation or other payment if the website is discontinued, if any content is inaccurate, or if any of our services are changed.
If you aren’t happy with the website, its content, or availability, your sole right and remedy is to stop using the website.
Our liability
To the extent permitted by law, we and third parties connected to us expressly exclude any liability for any loss or damage of any nature, such as any business losses, whether direct, indirect or consequential, including (without limitation) loss of or damage to profits, income, revenue, use, production, anticipated savings, business, contracts, commercial opportunities or goodwill incurred by any user in connection with our website, or in connection with the use, inability to use, or results of the use of our website, any websites linked to it and any materials posted on it, whether caused by tort (including negligence), breach of contract or otherwise, even if foreseeable.
Nothing in these Terms of Use limits our liability for death or personal injury arising from our negligence; fraudulent misrepresentation or misrepresentation as to a fundamental matter; or any other liability which cannot be excluded or limited under applicable law.
Restriction, Suspension and Termination
We may restrict, suspend or terminate your access to our website if we believe that you have breached these Terms of Use at any time. Any such restriction, suspension or termination will be without prejudice to any rights that we may have against you in respect of your breach of these Terms of Use. We may also remove the website as a whole or any sections or features of the website at any time.
DudeMeds LLC
TERMS OF SALE
Effective Date: January 1, 2024
THIS NOTICE DESCRIBES OUR TERMS OF SALE. PLEASE REVIEW IT CAREFULLY.
Introduction
The DudeMeds LLC (“DudeMeds”) website is owned and operated by DudeMeds LLC, a company incorporated in Delaware, USA.
These Terms of Sale affect your legal rights and obligations so please read them carefully. If you do not agree to be bound by these Terms of Sale, do not purchase products or services from us.
We’re at your disposal if you need any help or have any questions regarding our products and services. Simply drop an email to [email protected] or reach us through our Contact page.
We reserve the right to update these Terms of Sale from time to time at our discretion. If we do so, the updated version will be effective as soon as it is accessible. Please review these Terms of Sale before each order you place so that you are aware of any changes to them.
Other applicable terms
You should familiarize yourself with our entire legal section, which apply to your use of our website, and sets out the terms on which we handle the personal data you provide to us.
Compliance
As a healthcare service, we comply with all sorts of regulations, including but not limited to:
- Health Insurance Portability and Accountability Act (HIPAA): HIPAA is a federal law that regulates the privacy and security of protected health information (PHI). As a telemedicine company, DudeMeds comply with HIPAA’s requirements for handling and safeguarding PHI.
- Telemedicine laws and regulations: Each state in the USA has its own laws and regulations regarding telemedicine. DudeMeds comply with the laws and regulations of the states where it operates and where patients are located.
- Controlled Substances Act (CSA): The CSA is a federal law that regulates the manufacture, distribution, and dispensing of controlled substances. DudeMeds telemedicine company offers services related to controlled substances, which it complies with the CSA and other federal and state laws.
- Americans with Disabilities Act (ADA): The ADA is a federal law that prohibits discrimination against people with disabilities. DudeMeds ensures the telemedicine platform is accessible to people with disabilities, as well as trying to keep up with the latest technologies to continue to make access easy for all.
- Federal Trade Commission Act (FTC Act): The FTC Act is a federal law that regulates unfair or deceptive business practices. DudeMeds ensures that the telemedicine company does not engage in any unfair or deceptive practices.
- Children’s Online Privacy Protection Act (COPPA): COPPA is a federal law that regulates the collection of personal information from children under 13 years old. DudeMeds telemedicine company does NOT offers services to children or anyone under the age of 18.
ID verification
If you wish to order a prescription-only product, we will verify your identity automatically once your prescription has been approved by a member of our clinical team.
Our verification partners are:
- Vouched.ID –please view their privacy statement here.
Our verification partners will match your data to a database of public resources to determine whether the information you have provided us is indeed correct. The data we pass on to our verification partners are the following:
- First name and last name.
- Date of birth.
- Address.
- In some instances, IP address and other geolocation tags or information may be passed along
If we are unable to verify your identity in this way, you will receive an email asking you to provide us with a copy of your passport, driver’s license or other State issued ID. These are all securely stored with DudeMeds and are required in order to process your order if the verification carried out by our verification partners fails.
Our online consultations
Some of our products and services require you to complete an online consultation (a short questionnaire about your medical history that you take before purchasing a product/receiving a prescription). You must complete the online consultation truthfully and to the best of your knowledge. The online consultation should be completed by you, for you. It is very important that if you are unsure of an answer, you check it with your Primary Care Provider or overseeing physician. We and our partners, including our prescribers, will rely on your responses for the purposes of medical assessment and to determine if the product/prescription is suitable for you.
If you don’t understand something in the questionnaire, please contact us and we’ll give you any information you need. If you have any further questions, we recommend you contact your Primary Care Provider or overseeing physician.
You should always tell your Primary Care Provider or overseeing physician about any treatment and medication we supply.
Registration
By signing up with DudeMeds you are creating a secure online electronic patient record within DudeMeds which will contain the following information:
- A record of these Terms of Sale and the Privacy Policy and all Consent Forms which you accepted.
- Your personal details.
- Your treatments, consultations and test or lab results.
You acknowledge and agree that we may archive your electronic patient records including your personal information and treatments for a minimum of 7 years following your last order or prescription.
If there are any changes in your medical condition (new diagnosis, new medication, etc.) you are required to email [email protected] to let us know. Any updates in your medical situation could affect your suitability for treatment.
You are responsible for maintaining the confidentiality of your account and password and for restricting access to your computer to prevent unauthorized access to your account. Please contact us if you believe that someone has accessed your account without your permission.
Please do not register more than one account with DudeMeds and be sure to give us your correct name, address, date of birth, email and telephone number. Failure to do so may result in cancellation of your account.
Buying Products
You must be at least 18 years of age to make any purchases on DudeMeds and you must be a resident in the United States. We deliver products only to addresses in the United States. We reserve the right to cancel your order if you are using an address forwarding service. This is to ensure that we are restricting access to our services in geographies outside of the United States or across State lines.
Non-prescription
If you order a product that is a non-prescription medicine, you may still need to take an online consultation. In some cases, you may not need to take an online consultation and you will be charged for the product after placing your order. All products are subject to availability. We will inform you as soon as possible if the products ordered are not available and we will refund you all sums paid.
Prescription-only
At the end of the online consultation, you may be given the option to show a preference for a treatment option. Our clinical team and licensed prescribers need to know about your condition, any medication you may currently be using, potential allergies, and anything else that can help them assess whether the treatment you’ve selected is the right one for you.
A member of our clinical team will review your responses and assess your suitability for treatment. We may contact you via email, phone or sms for additional information if necessary. If you fail to respond to a request for more information, we will reject your request for a treatment.
We aim to process your request within 24 hours.
If we decide that your selected treatment is not suitable for you, we will reject your prescription and you will be notified via email. You may or may not be informed of the reasons for this rejection. Please note, if your request for treatment is rejected, you will not be charged. We only charge for approved prescriptions.
If we determine you are suitable for treatment, a prescription will be issued in your name. You will be charged for this prescription and your first prescription delivery will be passed on to our partner pharmacy.
Please note that professional codes of conduct and legal restrictions may limit the quantity and frequency of any product we and/or our partner pharmacy are permitted to supply to you.
Please note that for safety reasons, we do not accept returns of prescription medicines. In order to cancel your order:
- If this is your first order and your prescription has not been processed yet, please email [email protected] and we will be able to instruct our clinical team to reject your order. You will not be charged if the prescription has not been processed yet.
Repeat prescriptions
Most prescriptions are issued on a repeat basis.
The exact number of your repeat allowance is entirely dependent on our clinician’s medical assessment of your online consultation.
Your repeat prescription will expire in the two following cases, whichever comes first:
- After you have exhausted all of your repeats, or
- After the duration of your prescription has expired. For example, a prescription for 6 repeats expires 6 months after it is issued, and a prescription for 3 repeats expires 3 months after it is issued.
You will receive an email, phone or sms notification before your prescription expires to inform you of this. It will also include information on what steps to take in order to renew it.
You can cancel or pause your prescription at any time by contacting customer services at [email protected]. Alternatively, you can go to your DudeMeds Login, select your prescription under the “Your treatments” tab, and turn off automatic refills yourself. Once you have paused or canceled your subscription, you will no longer receive (or be charged for) automatically recurring prescriptions. However, please note that payment is taken 72 hours before your order is due to be sent out. If your medication has already been dispensed, we will be unable to issue you a refund.
If you have paused your subscription, you can still order a one-off delivery by changing it in your DudeMeds account (provided your subscription is still valid). This will action a one-off repeat to be dispensed to you.
Please note that we cannot dispense more medication than permitted on your prescription. You will therefore not be able to get more than one repeat every 30 days.
We reserve the right to cancel your subscription and not supply you with any further medication or products if you notify us of any significant side effects or adverse change in your medical condition, and we shall cancel your subscription if you inform us that you do not wish to receive further medication.
Consent for treatment
I hereby authorize DudeMeds pharmacy partners to provide products, supplies and services as prescribed by my physician. I confirm I have been informed and have participated in planning my care and
sign this consent willingly and voluntarily. I understand this consent is valid from the date of the start of initial therapy and I may withdraw my consent at any time by notice to DudeMeds LLC and, if I do so, the services thereafter will not be provided, but some payments may remain and shall be due.
Consent for payment
I clearly understand and agree that all services rendered to me may be charged directly to me, and that I am personally responsible for full payment. I understand that even if I suspend or
terminate treatment, the fees to purchase the medication for the first three (3) months are due, and if paid are non-refundable.
Lab Tests
All blood tests ordered through DudeMeds consist of:
- Delivery of a blood sample kit (“at-home”) produced by a third party laboratory that includes a pre-paid envelope for you to return the test in, as well as instructions on how to take a blood sample. Alternately, a lab requisition will be sent to yourself or to Quest Diagnostics or LabCorp for your blood tests. DudeMeds does not take insurance and plays no role in paying for your labs. We offer the requisition form, and you are solely 100% responsible to paying for any and all expenses incurred with labs, lab fee, lab processing and any other ancillary costs associated.
- Preparation of a report containing your personalized results and benchmarks for healthy results against the metrics you have chosen to test against. The blood testing process itself is carried out by a partner laboratory engaged by us. We reserve the right to change the laboratory from time to time without notice.
If the sample you return cannot be tested (for example, if the sample has coagulated or been damaged), then we will send you a replacement at no further cost. If that sample also cannot be tested, then we will refund you the Fee paid and advise that you visit your local laboratory to perform the test.
As part of our Lab Tests service, DudeMeds may offer you a consultation with a doctor to discuss your results further.
If you have any questions about our Blood Testing Services, please email [email protected] and we will arrange a more detailed conversation with a member of our team or a clinician.
Delivery of your products
We use registered delivery carriers in order to provide the best delivery service possible. Some products may or may not require a signature. Therefore, please be very careful if children or animals can access products delivered to you.
There may be instances where your delivery is delayed due to circumstances out of our control. We cannot assume responsibility for these delays, but we will do everything we can to ensure that the best service is provided to you.
If your delivery has been delayed by more than 7 days, please contact us.
If your delivery has been delayed being dispatched by one of our providers for any reason, you are entitled to request to cancel the delivery and receive a full refund.
Returns, cancellations, refunds
Please note that for safety reasons, we do not accept returns of medical products, including prescription or non-prescription medicine. If you have unwanted medicine please take it to a local pharmacy for safe disposal.
As this is the case we are unable to offer refunds for returned prescription treatments unless they fall under the below reasons.
In addition to your rights above you may return a product if it is damaged, defective, or if the wrong product has been sent to you. On some occasions we may require evidence such as a photo of damaged, defective, or wrongly received treatment. We are unable to reimburse the cost of return delivery.
You can cancel your order for prescription treatment up until the point it has been approved by a clinician.
For orders relating to non-medical products, you have 14 days to change your mind about the products beginning after the day you receive the products, unless they are split into several deliveries over different days. In this case you have until 14 days after the day you receive the last delivery to change your mind about the products. This excludes sealed products which are not suitable for return due to health or hygiene reasons (unless these items were damaged or faulty when delivered to you or have been incorrectly delivered).
If the product, including medical products, is damaged or defective, or the wrong treatment has been sent please let us know and we will either replace the product, or refund you the amount paid for you for the product in question.
You must return the product to us in accordance with our reasonable request as soon as possible after informing us that the product is damaged or defective. We are happy to accept requests for refunds for any products that are damaged, defective or have been issued in error, for up to 2 months after you received your item.
If you are entitled to a refund, the price paid for the product will be refunded to you by the same method that you used to pay. Refunds will be made once the matter is settled between our customer care team and yourself. You should expect your refund to reach your bank within 7-10 business days of it being issued.
If our delivery provider returns your package to our pharmacy or product partners, they utilize their own set of business practices. Some may be required to destroy the medication after a certain amount of time.
Use of the products
You are responsible for checking that the medicine is the correct medicine prescribed by us and that such medicine is not damaged in any way. Do not consume any medicine which is not the medicine prescribed or which is damaged on arrival. Instead you should contact us and we shall resupply or refund you as set out above.
All product information is for educational purposes and we make no assurances or guarantees as to its completeness, accuracy, or whether it is up to date.
Always read all product packaging and labels carefully before use.
If you purchase medicine in advance, please always check the date on the box to make sure it’s not out of date.
Please make sure that only you have access to your medicines.
In the event of a medical emergency, call 911 immediately.
All unused medication should be returned to your local pharmacy for safe disposal.
Cancellation by us
We may cancel your order if:
- We have insufficient stock to deliver the products you have ordered.
- We do not deliver to your delivery address.
- We cannot obtain authorization for your payment.
- We cannot verify your identity and you have ordered a prescription-only medicine.
- We cannot verify that you are aged 18 or over.
- One or more of the products you ordered was listed at an incorrect price due to an error in typing or an error in the pricing information received by us from our suppliers.
If we do cancel your order we will notify you by email and will refund you all sums paid within 30 days. We will not be obliged to offer any additional compensation for any disappointment suffered.
Our responsibility to you
All of the content on DudeMeds is to be considered general information and not intended to amount to medical advice. If you are seeking medical advice, you should contact a doctor or clinician and refrain from taking any action regarding your health based on the content of DudeMeds.com.
We cannot accept liability for any damages which result from:
- Your failure to provide (and continuously maintain) complete, truthful, and accurate information in your patient record, as well as in any online consultation you take with us and in any other information you give us.
- Your failure to follow advice given on DudeMeds, or to pass on relevant information to your regular healthcare provider.
We do not exclude or limit in any way our liability to you where it would be unlawful to do so. This includes liability for death or personal injury caused by our negligence or the negligence of our employees, agents, or subcontractors, and for fraud or fraudulent misrepresentation.
You agree that our service does not replace your general healthcare provider.
Making a complaint
Please contact us at [email protected].
General
If any provision of these Terms of Sale is held by a court of competent jurisdiction to be invalid or unenforceable, then such provision shall be construed, as nearly as possible, to reflect the intentions of the parties and all other provisions shall remain in full force and effect.
Our failure to exercise or enforce any right or provision of these Terms of Sale shall not constitute a waiver of such right or provision.
Our website does contain links to affiliate and other websites. DudeMeds LLC does not claim nor accept responsibility for any
privacy policies, practices and/or procedures of other such websites. Therefore, we encourage all users and visitors to be aware when they leave our website and to read the privacy statements of every website that collects personally identifiable information.
This Privacy Policy Agreement applies only and solely to the information collected by our website.
Notice to European Union Users
DudeMeds LLC’s operations are located primarily in the United States. If you provide information to us, the information will
be transferred out of the European Union (EU) and sent to the United States. (The adequacy decision on the EU-US Privacy
became operational on August 1, 2016. This framework protects the fundamental rights of anyone in the EU whose personal data is transferred to the United States for commercial purposes. It allows the free transfer of data to companies that are
certified in the US under the Privacy Shield.) By providing personal information to us, you are consenting to its storage and use as described in this Policy.
Security
DudeMeds LLC takes precautions to protect your information. When you submit sensitive information via the website, your information is protected both online and offline. Wherever we collect sensitive information (e.g. credit card information), that
information is encrypted and transmitted to us in a secure way. You can verify this by looking for a lock icon in the address bar and looking for “https” at the beginning of the address of the webpage. While we use encryption to protect sensitive information transmitted online, we also protect your information offline. Only employees who need the information to perform a specific job (for example, billing or customer service) are granted access to
personally identifiable information. The computers and servers in which we store personally identifiable information are kept in a secure environment. This is all done to prevent any loss, misuse, unauthorized access, disclosure or modification of the
user’s personal information under our control.
The company also uses Secure Socket Layer (SSL) for authentication and private communications to build users’ trust and
confidence in the internet and website use by providing simple and secure access and communication of credit card and personal information.
Acceptance of Terms
By using this website, you are hereby accepting the terms and conditions stipulated within the Privacy Policy Agreement. If you are not in agreement with our terms and conditions, then you should refrain from further use of our sites. In addition, your
continued use of our website following the posting of any updates or changes to our terms and conditions shall mean that you agree and acceptance of such changes.
How to Contact Us
If you have any questions or concerns regarding the Privacy Policy Agreement related to our website, please feel free to contact us at the following email, telephone number or mailing address.
Email: [email protected]
Telephone Number: 813-444-7995
DudeMeds LLC
HIPAA NOTICE OF PRIVACY PRACTICES
Effective Date: January 1, 2024
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The terms of this Notice of Privacy Practices (“Notice”) apply to DudeMeds LLC, its affiliates and its employees. DudeMeds LLC will share protected health information of patients as necessary to carry out treatment, payment, and health care operations as permitted by law. We are required by law to maintain the privacy of our patients’ protected health information and to provide patients with notice of our legal duties and privacy practices with respect to protected health information. We are required to abide by the terms of this Notice for as long as it remains in effect. We reserve the right to change the terms of this Notice as necessary and to make a new notice of privacy practices effective for all protected health information maintained by DudeMeds LLC. We are required to notify you in the event of a breach of your unsecured protected health information. We are also required to inform you that there may be a provision of state law that relates to the privacy of your health information that may be more stringent than a standard or requirement under the Federal Health Insurance Portability and Accountability Act (“HIPAA”). A copy of any revised Notice of Privacy Practices or information pertaining to a specific State law may be obtained by mailing a request to the Privacy Officer at the address below.
HIPAA CONSENT FORM WITH HITECH, CURES ACT, AND TELEHEALTH CONSENT
I, the undersigned patient or legal representative, hereby consent to the use and disclosure of my protected health information (PHI) by DudeMeds LLC for the purposes of providing telehealth services to me. I understand that PHI includes any information that identifies me or can be used to identify me, such as my name, date of birth, address, medical records, or any other information that relates to my health or healthcare.
I understand that my PHI may be used and disclosed for the following purposes:
To provide telehealth services, including diagnosis, treatment, and prescription of medication.
To coordinate my care with other healthcare providers involved in my treatment.
To obtain payment from my health insurance provider or other third-party payers for the services provided to me.
To conduct healthcare operations, such as quality assessment, staff training, and administrative activities.
I understand that my PHI will be protected in accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, the Health Information Technology for Economic and Clinical Health (HITECH) Act, and the 21st Century Cures Act. These laws require DudeMeds LLC to maintain the confidentiality and security of my PHI and to provide me with certain rights regarding my PHI, including the right to access, amend, and receive an accounting of disclosures of my PHI.
I understand that the telehealth services provided by DudeMeds LLC may involve the use of electronic communication technologies, such as videoconferencing, email, or text messaging. I understand that these technologies may not be secure or completely reliable, and that there may be risks associated with their use, such as interruptions in service, unauthorized access, or technical difficulties.
I understand that I have the right to refuse or withdraw my consent to the use and disclosure of my PHI for telehealth services at any time, and that such refusal or withdrawal will not affect my right to receive healthcare services from DudeMeds LLC. I understand that I may revoke this consent in writing, except to the extent that DudeMeds LLC has already taken action in reliance on this consent.
I understand that in the event of a breach of my PHI, DudeMeds LLC will comply with the HITECH Act Breach Notification Rule and will notify me in writing of the breach without unreasonable delay. I also understand that DudeMeds LLC will take reasonable and appropriate measures to mitigate any harm caused by the breach.
I understand that the 21st Century Cures Act allows for the sharing of my PHI for certain purposes, including public health activities, research, and treatment. I understand that DudeMeds LLC may share my PHI for these purposes, as allowed by law.
I have read and understand the information provided in this consent form, and I have had the opportunity to ask any questions that I may have regarding this form.
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION:
Authorization and Consent: Except as outlined below, we will not use or disclose your protected health information for any purpose other than treatment, payment or health care operations unless you have signed a form authorizing such use or disclosure. You have the right to revoke such authorization in writing, with such revocation being effective once we actually receive the writing; however, such revocation shall not be effective to the extent that we have taken any action in reliance on the authorization, or if the authorization was obtained as a condition of obtaining insurance coverage, other law provides the insurer with the right to contest a claim under the policy or the policy itself.
Uses and Disclosures for Treatment: We will make uses and disclosures of your protected health information as necessary for your treatment. Doctors and nurses and other professionals involved in your care will use information in your medical record and information that you provide about your symptoms and reactions to your course of treatment that may include procedures, medications, tests, medical history, etc.
Uses and Disclosures for Payment: We will make uses and disclosures of your protected health information as necessary for payment purposes. During the normal course of business operations, we may forward information regarding your medical procedures and treatment to your insurance company to arrange payment for the services provided to you. We may also use your information to prepare a bill to send to you or to the person responsible for your payment.
Uses and Disclosures for Health Care Operations: We will make uses and disclosures of your protected health information as necessary, and as permitted by law, for our health care operations, which may include clinical improvement, professional peer review, business management, accreditation, and licensing, etc. For instance, we may use and disclose your protected health information for purposes of improving clinical treatment and patient care.
Individuals Involved In Your Care: We may from time to time disclose your protected health information to designated family, friends and others who are involved in your care or in payment of your care in order to facilitate that person’s involvement in caring for you or paying for your care. If you are unavailable, incapacitated, or facing an emergency medical situation and we determine that a limited disclosure may be in your best interest, we may share limited protected health information with such individuals without your approval. We may also disclose limited protected health information to a public or private entity that is authorized to assist in disaster relief efforts for that entity to locate a family member or other persons that may be involved in some aspect of caring for you.
Business Associates: Certain aspects and components of our services are performed through contracts with outside persons or organizations, such as auditing, accreditation, outcomes data collection, legal services, etc. At times it may be necessary for us to provide your protected health information to one or more of these outside persons or organizations who assist us with our health care operations. In all cases, we require these associates to appropriately safeguard the privacy of your information.
Appointments and Services: We may contact you to provide appointment updates or information about your treatment or other health-related benefits and services that may be of interest to you. You have the right to request, and we will accommodate reasonable requests by you to receive communications regarding your protected health information from us by alternative means or at alternative locations. For instance, if you wish appointment reminders to not be left on voice mail or sent to a particular address, we will accommodate reasonable requests. With such request, you must provide an appropriate alternative address or method of contact. You also have the right to request that we not send you any future marketing materials and we will use our best efforts to honor such request. You must make such requests in writing, including your name and address, and send such writing to the Privacy Officer at the address below.
Research: In limited circumstances, we may use and disclose your protected health information for research purposes. In all cases where your specific authorization is not obtained, your privacy will be protected by strict confidentiality requirements applied by an Institutional Review Board which oversees the research or by representations of the researchers that limit their use and disclosure of your information.
Fundraising: We may use your information to contact you for fundraising purposes. We may disclose this contact information to a related foundation so that the foundation may contact you for similar purposes. If you do not want us or the foundation to contact you for fundraising efforts, you must send such request in writing to the Privacy Officer at the address below.
Other Uses and Disclosures: We are permitted and/or required by law to make certain other uses and disclosures of your protected health information without your consent or authorization for the following:
- Any purpose required by law;
- Public health activities such as required reporting of immunizations, disease, injury, birth and death, or in connection with public health investigations;
- If we suspect child abuse or neglect; if we believe you to be a victim of abuse, neglect or domestic violence;
- To the Food and Drug Administration to report adverse events, product defects, or to participate in product recalls;
- To your employer when we have provided health care to you at the request of your employer;
- To a government oversight agency conducting audits, investigations, civil or criminal proceedings;
- Court or administrative ordered subpoena or discovery request;
- To law enforcement officials as required by law if we believe you have been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law;
- To coroners and/or funeral directors consistent with law;
- If necessary to arrange an organ or tissue donation from you or a transplant for you;
- If you are a member of the military, we may also release your protected health information for national security or intelligence activities; and
- To workers’ compensation agencies for workers’ compensation benefit determination.
DISCLOSURES REQUIRING AUTHORIZATION:
Psychotherapy Notes: We must obtain your specific written authorization prior to disclosing any psychotherapy notes unless otherwise permitted by law. However, there are certain purposes for which we may disclose psychotherapy notes, without obtaining your written authorization, including the following: (1) to carry out certain treatment, payment or healthcare operations (e.g., use for the purposes of your treatment, for our own training, and to defend ourselves in a legal action or other proceeding brought by you), (2) to the Secretary of the Department of Health and Human Services to determine our compliance with the law, (3) as required by law, (4) for health oversight activities authorized by law, (5) to medical examiners or coroners as permitted by state law, or (6) for the purposes of preventing or lessening a serious or imminent threat to the health or safety of a person or the public.
Genetic Information: We must obtain your specific written authorization prior to using or disclosing your genetic information for treatment, payment or health care operations purposes. We may use or disclose your genetic information, or the genetic information of your child, without your written authorization only where it would be permitted by law.
Marketing: We must obtain your authorization for any use or disclosure of your protected health information for marketing, except if the communication is in the form of (1) a face-to-face communication with you, or (2) a promotional gift of nominal value.
Sale of Protected Information: We must obtain your authorization prior to receiving direct or indirect remuneration in exchange for your health information; however, such authorization is not required where the purpose of the exchange is for:
- Public health activities;
- Research purposes, provided that we receive only a reasonable, cost-based fee to cover the cost to prepare and transmit the information for research purposes;
- Treatment and payment purposes;
- Health care operations involving the sale, transfer, merger or consolidation of all or part of our business and for related due diligence; • Payment we provide to a business associate for activities involving the exchange of protected health information that the business associate undertakes on our behalf (or the subcontractor undertakes on behalf of a business associate) and the only remuneration provided is for the performance of such activities;
- Providing you with a copy of your health information or an accounting of disclosures;
- Disclosures required by law;
- Disclosures of your health information for any other purpose permitted by and in accordance with the Privacy Rule of HIPAA, as long as the only remuneration we receive is a reasonable, cost-based fee to cover the cost to prepare and transmit your health information for such purpose or is a fee otherwise expressly permitted by other law; or
- Any other exceptions allowed by the Department of Health and Human Services.
RIGHTS THAT YOU HAVE REGARDING YOUR PROTECTED HEALTH INFORMATION:
Access to Your Protected Health Information: You have the right to copy and/or inspect much of the protected health information that we retain on your behalf. For protected health information that we maintain in any electronic designated record set, you may request a copy of such health information in a reasonable electronic format, if readily producible. Requests for access must be made in writing and signed by you or your legal representative. You may obtain a “Patient Access to Health Information Form” from the front office person. You will be charged a reasonable copying fee and actual postage and supply costs for your protected health information. If you request additional copies you will be charged a fee for copying and postage.
Amendments to Your Protected Health Information: You have the right to request in writing that protected health information that we maintain about you be amended or corrected. We are not obligated to make requested amendments, but we will give each request careful consideration. All amendment requests, must be in writing, signed by you or legal representative, and must state the reasons for the amendment/correction request. If an amendment or correction request is made, we may notify others who work with us if we believe that such notification is necessary. You may obtain an “Amendment Request Form” from the front office person or individual responsible for medical records.
Accounting for Disclosures of Your Protected Health Information: You have the right to receive an accounting of certain disclosures made by us of your protected health information after April 14, 2003. Requests must be made in writing and signed by you or your legal representative. “Accounting Request Forms” are available from the front office person or individual responsible for medical records. The first accounting in any 12-month period is free; you will be charged a fee for each subsequent accounting you request within the same 12-month period. You will be notified of the fee at the time of your request.
Restrictions on Use and Disclosure of Your Protected Health Information: You have the right to request restrictions on uses and disclosures of your protected health information for treatment, payment, or health care operations. We are not required to agree to most restriction requests but will attempt to accommodate reasonable requests when appropriate. You do, however, have the right to restrict disclosure of your protected health information to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law, and the protected health information pertains solely to a health care item or service for which you, or someone other than the health plan on your behalf, has paid DudeMeds LLC in full. If we agree to any discretionary restrictions, we reserve the right to remove such restrictions as we appropriate. We will notify you if we remove a restriction imposed in accordance with this paragraph. You also have the right to withdraw, in writing or orally, any restriction by communicating your desire to do so to the individual responsible for medical records.
Right to Notice of Breach: We take very seriously the confidentiality of our patients’ information, and we are required by law to protect the privacy and security of your protected health information through appropriate safeguards. We will notify you in the event a breach occurs involving or potentially involving your unsecured health information and inform you of what steps you may need to take to protect yourself.
Paper Copy of this Notice: You have a right, even if you have agreed to receive notices electronically, to obtain a paper copy of this Notice. To do so, please submit a request to the DudeMeds LLC at the address below.
Complaints: If you believe your privacy rights have been violated, you can file a complaint in writing with the Privacy Officer. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services at the below address. There will be no retaliation for filing a complaint. Office for Civil Rights Department of HHS Jacob Javits Federal Building 26 Federal Plaza – Suite 3312 New York, NY 10278 Voice Phone (212) 264-3313 FAX (212) 264-3039 TDD (212) 264-2355 For Further Information: If you have questions, need further assistance regarding or would like to submit a request pursuant to this Notice, you may contact the DudeMeds LLC by phone at (813)444-7995 or at the following email address: [email protected]. This Notice of Privacy Practices is also available on our DudeMeds LLC web page at www.dudemeds.com/legal.
DudeMeds LLC
PATIENT TELEHEALTH CONSENT FORM
Effective Date: January 1, 2024
THIS NOTICE DESCRIBES YOUR CONSENT FOR TELEHEALTH. PLEASE REVIEW IT CAREFULLY.
Thank you for the opportunity to serve you! We look forward to becoming your partner in your health care and understanding your health care needs better. Please review the follow consents PRIOR to your visit with us. We will ask you for your consent via electronic measures if you had the opportunity to review the consents and allow you the opportunity to ask any questions.
General Consent for Care and Treatment. I have the right, as a patient, to be informed about my condition and the recommended surgical, medical or diagnostic procedure to be used so that I may make the decision whether or not to undergo any suggested treatment or procedure after knowing the risks and hazards involved. At this point in my care, no specific treatment plan has been recommended. This consent form is simply an effort to obtain your permission to perform the evaluation necessary to identify the appropriate treatment and/or procedure for any identified condition(s). This consent provides us with your permission to perform reasonable and necessary medical examinations, testing and treatment. By my electronic consent, I am indicating that (1) I intend that this consent is continuing in nature even after a specific diagnosis has been made and treatment recommended; and (2) I consent to treatment at this office or any other satellite office under common ownership. The consent will remain fully effective until it is revoked. I have the right at any time to discontinue services. I have the right to discuss the treatment plan with my physician about the purpose, potential risks and benefits of any test ordered for me. If I have any concerns regarding any test or treatment recommend by my health care provider, I am encouraged to ask questions. I voluntarily request a physician, and/or mid-level provider (nurse practitioner, physician assistant, or clinical nurse specialist), and other health care providers or the designees as deemed necessary, to perform reasonable and necessary medical examination, testing and treatment for the condition which has brought me to seek care at this practice. I certify that I have read and fully understand the above statements and consent fully and voluntarily to its contents.
Consent to Treatment Using Telemedicine. I consent to treatment involving the use of electronic communications to enable health care providers at different locations to share my individual patient medical information for diagnosis, therapy, follow-up, and/or education purposes. I consent to forwarding my information to a third party as needed to receive telemedicine services, and I understand that existing confidentiality protections apply. I acknowledge that while telemedicine can be used to provide improved access to medical care, as with any medical procedure, there are potential risks and no results can be guaranteed or assured. These risks include, but are not limited to: technical problems with the information transmission; equipment failures that could result in lost information or delays in treatment. I understand that I have a right to withhold or withdraw my consent to the use of telemedicine in the course of my care at any time, without affecting my right to future treatment and without risking the loss or withdrawal of any program benefits to which I would otherwise be entitled.
Patient Consent and Acknowledgement form for Privacy Notice of Privacy Practice/clinics.
I acknowledge that I have received the Notice of Privacy Practice, which describes the ways in which the practice/clinic may use and disclose my healthcare information for its treatment, payment, healthcare operations and other described and permitted uses and disclosures, I understand that I may contact the Privacy Officer designated on the notice if I have a question or complaint. I understand that this information may be disclosed electronically by the Provider and/or the Provider’s business associates. To the extent permitted by law, I consent to the use and disclosure of my information for the purposes described in the Notice of Privacy Practice. Disclosures to Friends and/or Family Members. I may give permission for my Protected Health Information to be disclosed for purposes of communicating results, findings and care decisions to the family members and others. I will communicate the Name, Relationship, and contact information to the clinical team to ensure it is documented. Communications about My Healthcare. I agree the Provider or an agent of the Provider or an independent physician’s office may contact me for the purposes of scheduling necessary follow-up visits recommended by the treating physician. Note: This location uses an Electronic Health Record that will update all your demographics and consents to the information that you just provided. Please note this information will also be updated for your convenience to all our affiliated locations that share an electronic health record in which you have a relationship. Consent for Photographing or Other Recording for Security and/or Health Care Operations. I consent to photographs, digital or audio recordings, and/or images of me being recorded for patient care, security purposes and/or the practice’s/clinic’s health care operations purposes (e.g., quality improvement activities). I understand that the practice/clinic retains the ownership rights to the images and/or recordings. I will be allowed to request access to or copies of the images and/or recordings when technologically feasible unless otherwise prohibited by law. I understand that these images and/or recordings will be securely stored and protected. Images and/or recordings in which I am identified will not be released and/or used outside the facility without a specific written authorization from me or my legal representative unless otherwise permitted or required by law. Consent to Email, Cellular Telephone, or Text Usage for Appointment Reminders and Other Healthcare Communications. If at any time I provide an email address or cellphone number at which I may be contacted, I consent to receiving un secure instructions and other healthcare communications at the email or text address I have provided or you have obtained, at any text number forwarded, or transferred from that number. These instructions may include, but not be limited to: post-procedure instructions, follow-up instructions, educational information, and prescription information. Other healthcare communications may include, but are not limited to, communications to family or designated representatives regarding my treatment or condition, or reminder messages to me regarding appointments for medical care. Note: You may opt out of these communications at any time. The practice/clinic does not charge for this service, but standard text messaging rates or cellular telephone minutes may apply as provided in your wireless plan (contact your carrier for pricing plans and details). Release of Information. I hereby permit practice/clinic and the physicians or other health professionals involved in the inpatient or outpatient care to release healthcare information for purposes of treatment, payment, or healthcare operations. Healthcare information regarding a prior service(s) at other DudeMeds LLC affiliated providers may be made available to subsequent DudeMeds LLC affiliated providers to coordinate care.
DudeMeds LLC
INFORMED CONSENT FOR TESTOSTERONE REPLACEMENT THERAPY
Effective Date: January 1, 2024
THIS NOTICE DESCRIBES OUR INFORMED CONSENT FOR TESTOSTERONE REPLACEMENT THERAPY. PLEASE REVIEW IT CAREFULLY.
Although Testosterone Replacement Therapy (“TRT”) has been utilized safely and effectively, it is necessary to discuss potential risks. You should also be aware of the alternatives to TRT, including not receiving the treatment. It is important that you consider the information we have provided you. Be sure that you are doing what is right for you. If you are unsure, then perhaps you should take some time to weigh your options or consult another health care provider. Please review the following items, which discuss informed consent. Your clinical provider will attempt to answer all of your questions to your satisfaction. Initial beside each statement that you have read, understand, and agree with:
This is my consent for DudeMeds LLC, including any clinical provider who works with/for DudeMeds LLC, to begin treatment for TRT in oral, pellet, injection or gel form.
It has been explained to me, and I fully understand, that occasionally there are complications with this treatment such as gynocomastia, acne, fat loss, and increased estrogens.
I understand I may retain extra fluid in the body – This can cause problems for patients with heart, kidney, or liver disease. TRT may cause your LH and FSH levels to be severely limited, affecting your fertility. Patients should not be on TRT if attempting to father a child. I have been informed that Testosterone may lead to liver inflammation and damage. I have been informed that I will be monitored for liver problems before starting TRT and periodically during therapy.
TRT may cause changes in cholesterol levels, red blood cell levels, PSA levels, liver function enzymes, and other hormone levels which will be monitored with periodic blood tests. I understand it is my responsibility to be aware of the above complications and let my clinical provider know when I have a concern. I understand that I will have periodic blood tests to monitor my blood levels. I understand there is no guarantee as to the result and that if I stop treatment, my condition may return or get worse.
I have provided DudeMeds LLC with my complete past medical and health history. I have had an opportunity to provide DudeMeds LLC with my complete past medical and health history along with all other information I felt necessary for my medications. All of my questions concerning the risks, benefits, and alternatives have been answered. I am satisfied with the answers.
I agree that TRT works best when I change lifestyle habits such as limiting alcohol, stopping smoking, exercising, and eating correctly. All of my questions and concerns regarding treatment have been answered to my satisfaction.
I further acknowledge that the risks and benefits of this treatment have been explained to me. I am of sound mind, under no undue influence and am competent to make this decision and do so of my own free will. I have no further questions. I consent to taking Testosterone as proposed by DudeMeds, LLC and/or my clinical provider. I have complete understanding of and agree to follow the terms of this Informed Consent. A copy of this document is available at dudemeds.com/legal.
