1,432,164
Humans Served
1,432,164
Humans Served
CodyMD
CODYMD
Last Updated: April 30, 2026
This Telehealth Informed Consent ("Consent") provides you with important information about receiving healthcare services through telehealth technology via the CodyMD platform, operated by Awesome Studios, LLC d/b/a CodyMD ("CodyMD"). Please read this Consent carefully before receiving any Clinical Services through CodyMD.
CodyMD is a technology platform that facilitates your access to telehealth services provided by independent licensed healthcare providers ("Providers"). Providers may be affiliated with MD Integrations https://mdintegrations.com, an independent medical group with its own provider network with which CodyMD contracts to make clinical services available to patients, or may be independent contractor providers who deliver care directly through the CodyMD platform. CodyMD does not practice medicine, does not employ Providers for the purpose of delivering clinical care, and does not direct or control the independent clinical judgment of any Provider.
Clinical Services through CodyMD are currently available only to patients physically located in Oregon or Washington at the time of the clinical encounter. CodyMD's informational services (including AI-powered health education and information tools) are available more broadly, but no medical care, diagnosis, treatment, or prescription is provided through informational services.
Your consent to receive telehealth services is voluntary. You have the right to withdraw your consent at any time without affecting your right to future care or treatment, or your eligibility for benefits to which you would otherwise be entitled.
Telehealth is the delivery of healthcare services using electronic communications, information technology, and related technologies when you and your Provider are not in the same physical location.
The CodyMD telehealth model is principally asynchronous. This means:
You will provide information about your symptoms, medical history, and current medications through the CodyMD platform, including written responses, photographs where relevant, and other electronically transmitted information.
An independent licensed Provider will review the information you provide on a store-and-forward basis. The Provider does not need to be present at the same time you submit your information.
After review, your Provider will determine whether they are able to evaluate your condition and provide care via telehealth, whether additional information is needed, whether a synchronous (real-time) audio or video encounter is necessary, or whether your condition is not appropriate for telehealth and requires in-person evaluation.
A synchronous audio or video encounter may be initiated by your Provider at any time during the clinical encounter, in the Provider's professional judgment, when warranted by your clinical presentation or required by applicable state law. Your Provider will use a HIPAA-compliant audio or video platform for any synchronous encounter. You will be notified before any synchronous encounter and may decline.
In addition to the principal asynchronous workflow, telehealth services through the CodyMD platform may include:
Secure messaging between you and your Provider for follow-up questions, care coordination, and non-urgent communications.
Remote review of health data and laboratory results that you submit through the platform.
Electronic transmission of prescriptions to pharmacies of your choice.
Care coordination with other healthcare providers when authorized by you.
Clinical services through the CodyMD platform may include, within the scope of each Provider's licensure, primary care, urgent care, treatment of acute conditions, prescription management for established conditions, laboratory ordering and interpretation, and other services your Provider determines are appropriate for telehealth delivery.
Potential benefits of telehealth services through CodyMD include:
Increased access to healthcare for patients in areas with limited in-person provider availability.
Convenience of receiving evaluation and care from home or other private locations.
Reduced travel time and associated costs.
Timely access to licensed clinicians for non-emergency conditions.
Electronic access to your medical records, prescriptions, and Provider communications through the platform.
Asynchronous communication that does not require both you and your Provider to be present at the same time, which can facilitate care for patients with limited daytime availability.
You understand and acknowledge the following risks and limitations of telehealth, including those specific to asynchronous (store-and-forward) telehealth as practiced through CodyMD:
Telehealth is not appropriate for all medical conditions. Your Provider will determine whether telehealth is suitable for your specific situation.
Your Provider will not be able to perform a hands-on physical examination, which may limit the Provider's ability to diagnose or treat certain conditions.
Asynchronous review depends entirely on the accuracy and completeness of information you provide. Without the back-and-forth of a real-time encounter, the Provider may not be able to clarify ambiguous or incomplete information, which may lead to delays, requests for additional information, or recommendations to seek in-person care.
Your Provider may determine that telehealth is insufficient for your clinical needs and may recommend an in-person visit, referral to a specialist, or emergency care. You agree to follow such recommendations.
Delays in evaluation and treatment may occur due to the asynchronous nature of the workflow, technology limitations, or Provider availability.
There is a risk that your Provider's assessment may be limited or incorrect due to the inability to perform a physical examination, the inherent limitations of telehealth technology, or incomplete or inaccurate information provided by you.
Your Provider may decline to provide treatment in their sole professional discretion, including for clinical reasons, jurisdictional reasons, or other reasons. There is no guarantee that you will receive any particular treatment, prescription, or diagnosis.
Telehealth services depend on technology, including your internet connection, device, and software. Technology failures, interruptions, or poor connectivity may disrupt or prevent the delivery of services.
Despite reasonable security measures, there is a risk that electronic communications could be intercepted, corrupted, or otherwise compromised.
For asynchronous communications, there may be lower-quality images or insufficient information that affect your Provider's ability to evaluate your condition. Your Provider may request additional information or photographs.
For synchronous encounters where applicable, there may be audio or video quality issues that affect the encounter. Your Provider may attempt to reconnect, contact you by alternative means, or reschedule.
Although CodyMD implements administrative, physical, and technical safeguards in accordance with HIPAA to protect your health information, there are inherent risks to the transmission of information over the internet. Unauthorized access to your information is possible despite these safeguards. Please review our Privacy Policy at https://cody.md/privacy for detailed information about how we protect your data.
You are responsible for:
Ensuring that your telehealth interactions take place in a private location where others cannot overhear or view your information or any synchronous encounter.
Avoiding the use of public or shared computers or unsecured Wi-Fi networks for telehealth interactions.
Maintaining the confidentiality of your account credentials.
By consenting to receive telehealth services, you agree to the following:
You agree to provide accurate, current, and complete health information to your Provider, including your medical history, current medications, allergies, symptoms, and any other information relevant to your care. You understand that your Provider will rely on the accuracy and completeness of the information you provide, and that inaccurate or incomplete information may adversely affect your diagnosis and treatment. Providing knowingly false information may constitute fraud and may have legal consequences.
You must be physically located in Oregon or Washington at the time you receive Clinical Services through CodyMD. Your Provider must hold an active, unrestricted license in the state where you are physically located. You agree to accurately disclose your physical location at the time of each clinical encounter.
CodyMD uses geolocation, address verification, and government-issued identification verification to confirm your physical location and eligibility. Misrepresenting your location, identity, or eligibility may result in immediate termination of services without refund of any fees already captured, may void any clinical recommendations you have received, and may have legal consequences.
You agree to provide a valid, government-issued photo identification when requested by CodyMD. Identity verification is required for clinical services and is used to confirm that you are the patient receiving care, to verify your physical location, and to comply with applicable laws.
You are responsible for having a reliable internet connection and a device (computer, tablet, or smartphone) capable of accessing the CodyMD platform. For any synchronous encounters that may be initiated by your Provider, you are responsible for having functioning audio and video capabilities. CodyMD is not responsible for technology failures on your end.
You are responsible for ensuring that your interactions with CodyMD and your Provider take place in a private, secure environment where others cannot inadvertently see or hear your information or any synchronous encounter. If a third party will be present during a synchronous encounter, you should inform your Provider in advance.
You agree to follow your Provider's recommendations regarding follow-up care, including in-person visits, specialist referrals, laboratory testing, or emergency care when recommended. You understand that failure to follow recommended care may adversely affect your health outcomes, and that CodyMD and your Provider have no liability for outcomes resulting from your failure to follow recommended care.
THE CODYMD PLATFORM IS NOT DESIGNED FOR MEDICAL EMERGENCIES.
IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, STOP USING THE PLATFORM IMMEDIATELY AND CALL 911, GO TO YOUR NEAREST EMERGENCY ROOM, OR CALL YOUR LOCAL EMERGENCY SERVICES.
Examples of medical emergencies include, but are not limited to:
Chest pain or pressure
Difficulty breathing or shortness of breath
Severe bleeding or trauma
Loss of consciousness or fainting
Stroke symptoms (sudden numbness, confusion, difficulty speaking, severe headache, vision changes, or loss of balance)
Severe allergic reactions
Poisoning or overdose
Thoughts of harming yourself or others (see Section 11 for mental health crisis resources)
Severe abdominal pain
Pregnancy complications, including bleeding, severe pain, or contractions
Any condition requiring immediate medical attention
If you submit information through the CodyMD platform that indicates a medical emergency, the platform may automatically display emergency resource information. CodyMD's display of automated information in response to symptom keywords does not constitute medical evaluation. Always call 911 or go to an emergency room for medical emergencies, regardless of any automated response from the platform.
Your Provider may also determine during a clinical encounter that your condition requires emergency or in-person care and may direct you to seek such care immediately. You agree to follow such direction.
By receiving Clinical Services through the CodyMD platform, you establish a provider-patient relationship with the individual Provider who delivers your care. Providers may be affiliated with MD Integrations https://mdintegrations.com, an independent medical group with which CodyMD contracts to make clinical services available to CodyMD patients, or may be independent contractor Providers who deliver care directly through the CodyMD platform. The provider-patient relationship is between you and your individual Provider. CodyMD is not a party to this relationship and does not practice medicine.
The provider-patient relationship is established when, and only when, your Provider reviews your case, accepts the case, and initiates clinical care. Submitting information through the CodyMD platform, authorizing payment, or completing the intake process does not, by itself, create a provider-patient relationship. If your Provider declines to accept your case, no provider-patient relationship is created and no payment is captured (see Section 8).
Your Provider exercises independent professional judgment in all clinical decisions, including decisions about diagnosis, treatment, prescriptions, referrals, and whether telehealth is appropriate for your condition. CodyMD does not direct, control, or influence the clinical decisions of any Provider.
Your Provider may decline to provide treatment or may recommend alternative care, including in-person evaluation, at any time in the Provider's sole professional discretion. There is no guarantee that you will receive any particular treatment, prescription, or diagnosis.
If your Provider determines that a prescription medication is appropriate for your condition, your Provider may electronically transmit the prescription to a pharmacy of your choice or to a partnered pharmacy. You understand and agree to the following:
Your Provider has sole discretion over whether to prescribe any medication, including the type, dosage, and duration of any prescription. There is no guarantee that any particular prescription will be issued.
Certain medications, including most controlled substances, may not be prescribed via telehealth due to federal and state regulatory restrictions, the Ryan Haight Act, your Provider's clinical judgment, or other applicable rules.
You are responsible for informing your Provider of all medications you are currently taking, including over-the-counter medications, supplements, and herbal remedies, to avoid dangerous interactions.
You are responsible for following your Provider's instructions regarding prescribed medications and for promptly reporting any adverse reactions to your Provider or to your nearest emergency facility, as appropriate.
Pharmacy services are provided by independently owned and licensed pharmacies. CodyMD does not operate a pharmacy and is not responsible for the acts or omissions of any pharmacy.
All Clinical Services provided through the CodyMD platform are on a direct-pay (self-pay) basis only. CodyMD collects fees on behalf of Providers as an administrative service. Neither CodyMD nor any Provider will submit claims to health insurance plans, Medicare, Medicaid, HMOs, or any other third-party payor for Clinical Services rendered through the platform. If you wish to seek reimbursement from your insurer, you are solely responsible for submitting any claims, and reimbursement is not guaranteed.
When you request Clinical Services, CodyMD authorizes a payment hold on your selected payment method through Stripe but does not capture (charge) the payment at the time of authorization. Payment is captured only after a licensed Provider reviews your case and accepts it for treatment. If your Provider declines your case for any reason — including clinical reasons, jurisdictional ineligibility, lapsed Provider licensure, identity or address verification failure, or any other reason — the authorization is canceled and no payment is captured. You will not be charged for declined cases.
This means:
The amount displayed at the time of payment authorization is the amount you have authorized but have not yet been charged.
A pending authorization may temporarily appear on your card statement as a hold; this hold is released if your case is declined.
Your card or bank may show the authorization for several business days after a declined case before the hold is fully released; CodyMD has no control over how quickly the issuing institution releases authorizations.
Once payment is captured (i.e., after Provider acceptance and initiation of clinical care), the standard refund and dispute provisions in the Terms of Use apply.
Fees for Clinical Services are disclosed before you authorize payment. By proceeding, you agree to pay the disclosed fees if and when your case is accepted by a Provider.
Your telehealth encounter and associated health information are protected by federal and state privacy laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the HITECH Act, and applicable state privacy laws (including the Washington My Health My Data Act for Washington residents).
CodyMD operates as a Business Associate under HIPAA with respect to Protected Health Information (PHI) handled on behalf of Providers and contracted medical groups, including MD Integrations. CodyMD maintains Business Associate Agreements as required by HIPAA and implements administrative, physical, and technical safeguards to protect the confidentiality, integrity, and availability of your PHI. Detailed information about CodyMD's privacy and HIPAA practices is available in the Privacy Policy and HIPAA Notice of Privacy Practices at https://cody.md/privacy.
CodyMD uses third-party identity verification services to confirm your identity before clinical services are provided. As part of identity verification, you may be asked to upload a government-issued photo identification and to provide other identifying information. Identity verification information is used to confirm that you are the patient receiving care, to verify your physical location, to support prescription workflows, and to comply with applicable laws. Identity verification information is handled in accordance with the Privacy Policy.
Your Provider will create and maintain medical records of your telehealth encounters in accordance with applicable law. CodyMD stores medical records on HIPAA-compliant infrastructure for a minimum of seven (7) years from the date of the last encounter, or longer where required by state law. Your rights regarding access to, amendment of, accounting of disclosures from, and other actions related to your medical records are described in the HIPAA Notice of Privacy Practices.
You agree not to record (audio, video, or otherwise) any telehealth encounter without the prior written consent of your Provider. CodyMD and your Provider will not record encounters without your prior consent, except as required for clinical documentation purposes consistent with applicable law and Provider professional obligations.
CodyMD operates AI-powered tools (the "AI Tools") that provide general health information and education. The AI Tools do not provide medical advice, diagnosis, treatment, or prescription. The AI Tools do not establish a patient-provider relationship. Any clinical care, including all medical advice, diagnosis, treatment, and prescriptions, is provided exclusively by independent licensed Providers as described in this Consent and the Terms of Use.
The AI Tools may discuss general information about symptoms, conditions, medications, and health topics. The AI Tools may help you prepare to discuss your health with a clinician. The AI Tools do not replace evaluation by a licensed clinician.
The AI Tools are imperfect and may produce information that is incomplete, outdated, or incorrect. You acknowledge that:
Information provided by the AI Tools must not be relied upon as medical advice.
Any decision regarding your health should be made in consultation with a licensed clinician.
Failure to seek timely care from a licensed clinician based on information from the AI Tools may result in serious harm, for which CodyMD bears no liability.
You will not use the AI Tools as your sole source of health information and will not make significant health decisions based solely on AI Tool output.
Conversations you have with the AI Tools are stored by CodyMD as described in the Privacy Policy. CodyMD does not use individually identifiable user conversations to train third-party AI models. [NOTE TO COUNSEL: Confirm with internal AI/engineering team. If CodyMD does train its own internal models on user conversations after de-identification, this language should be made specific. The current draft is conservative.]
When you transition from the AI Tools to Clinical Services, your Provider may review information you have shared with the AI Tools as part of your clinical encounter. Your Provider exercises independent professional judgment in any clinical decision and is not bound by AI Tool output.
CodyMD does not provide mental, emotional, or behavioral health care services. You agree not to use Clinical Services for any mental, emotional, or behavioral health concerns, including but not limited to:
Depression, anxiety, or other mood disorders
Suicidal thoughts, self-harm, or thoughts of harming others
Substance use disorders
Eating disorders
Psychiatric conditions or psychiatric crises
Other mental, emotional, or behavioral health conditions
If you are experiencing a mental health crisis, please contact the 988 Suicide and Crisis Lifeline by calling or texting 988, contact the Crisis Text Line by texting HOME to 741741, or call 911 or go to your nearest emergency room.
If you are seeking ongoing mental or behavioral health care, please consult directly with a licensed mental health professional in your jurisdiction. CodyMD's AI Tools may automatically detect certain mental or behavioral health-related queries and direct you to appropriate resources; this is not a substitute for evaluation by a licensed mental health professional.
CodyMD implements multiple safeguards to ensure that Clinical Services are provided only to eligible patients in jurisdictions where CodyMD's contracted Providers are licensed:
Geolocation. At the time of clinical service request, CodyMD uses geolocation technology to determine your approximate physical location.
Patient Self-Declaration. You are required to disclose your physical location at the time of clinical service request.
Identity Verification. You are required to provide a valid government-issued photo identification, which is verified against your self-disclosed information.
Address Verification. Your delivery address (where applicable, for prescriptions or other physical fulfillment) is verified against your identification and other information.
Provider Licensure Monitoring. CodyMD and MD Integrations monitor Provider licensure status on an ongoing basis. A Provider with a lapsed, suspended, or revoked license may not accept cases through the platform.
Payment Hold. As described in Section 8, payment is authorized but not captured until a Provider accepts your case. If any of the above verification steps fails — including jurisdictional ineligibility, identity verification failure, or Provider licensure issues — your case is declined and no payment is captured.
These safeguards operate together to prevent payment from, and Clinical Services to, jurisdictions where CodyMD does not operate or where the assigned Provider is not licensed.
As a patient receiving telehealth services through the CodyMD platform, you have the right to:
Withdraw your consent to receive telehealth services at any time without affecting your right to future care or your eligibility for benefits.
Refuse any proposed treatment and be informed of the consequences of such refusal.
Request an in-person visit or referral to an in-person provider at any time, recognizing that CodyMD does not directly provide in-person care.
Decline a synchronous (real-time audio or video) encounter if your Provider proposes one, recognizing that this may affect your Provider's ability to evaluate your condition.
Access your medical records in accordance with applicable law.
Request amendments to your medical records.
Request an accounting of disclosures of your PHI.
Receive information about the identity, qualifications, and licensure of your Provider.
Receive a copy of this Consent.
File a complaint about your care, the privacy of your health information, or any other aspect of your experience, as described in the Privacy Policy and HIPAA Notice of Privacy Practices. CodyMD will not retaliate against you for filing a complaint.
Be treated with respect and dignity regardless of race, ethnicity, national origin, religion, gender, sexual orientation, age, disability, or other protected characteristic.
Clinical Services through CodyMD are currently available only to patients physically located in Oregon or Washington at the time of the clinical encounter. Clinical Services are not available in any other state or territory at this time. CodyMD's informational services are available more broadly but do not constitute medical care.
If CodyMD expands clinical services to additional jurisdictions in the future, this Consent will be updated to reflect the additional state-specific provisions, and patients in those new jurisdictions will be required to acknowledge the updated Consent before receiving services.
For patients in Oregon, the following additional provisions apply:
Your Provider is licensed in Oregon by the Oregon Medical Board or the applicable licensing authority for the Provider's profession.
Your Provider will exercise the same standard of care via telehealth that would apply to in-person services in Oregon.
Your Provider will comply with all applicable Oregon laws and regulations regarding telehealth, including those of the Oregon Medical Board, the Oregon State Board of Pharmacy with respect to prescriptions, and any other applicable regulatory body.
You have the right to receive a copy of your medical records, request corrections, and receive an explanation of your diagnosis and treatment in accordance with Oregon law.
You may file complaints regarding the care you receive with the Oregon Medical Board or other applicable Oregon licensing authority.
For patients in Washington, the following additional provisions apply:
Your Provider is licensed in Washington by the Washington Medical Commission or the applicable licensing authority for the Provider's profession.
Your Provider will comply with all applicable Washington telehealth regulations, including those of the Washington Medical Commission and the Washington State Department of Health.
You have the right to be informed of your Provider's qualifications, licensure status, and the location from which they are providing services, and may request this information at any time.
You may request an in-person visit at any time, recognizing that CodyMD does not directly provide in-person care.
Your consumer health data is also protected under the Washington My Health My Data Act, and you have additional rights regarding your consumer health data as described in the Privacy Policy.
You may file complaints regarding the care you receive with the Washington Medical Commission or other applicable Washington licensing authority.
You understand that CodyMD is a technology platform that facilitates your access to telehealth services. CodyMD is not liable for the clinical decisions, acts, or omissions of any Provider, MD Integrations, or any pharmacy. The provider-patient relationship, when established, is between you and your Provider, and your Provider is solely responsible for the clinical care you receive.
CodyMD is not liable for any loss, injury, or damage resulting from technology failures, internet service interruptions, or other circumstances beyond CodyMD's reasonable control that affect the delivery of telehealth services.
Additional limitations of liability are set forth in the CodyMD Terms of Use, available at https://cody.md/terms, which are incorporated by reference into this Consent.
By electronically signing this Consent (e.g., by checking the "I agree" box on the CodyMD platform) or by signing below, I acknowledge and agree that:
I have read (or have had the opportunity to read) and understand this Telehealth Informed Consent.
I understand what telehealth is, including its potential benefits, risks, and limitations as described above, and specifically that CodyMD's principal model is asynchronous (store-and-forward) review with synchronous escalation at the Provider's discretion.
I understand that telehealth is not appropriate for all medical conditions and that my Provider may recommend in-person care.
I understand that the CodyMD platform is not designed for medical emergencies and that I should call 911 or go to an emergency room in the event of a medical emergency.
I understand that CodyMD is a technology platform and does not practice medicine or direct the clinical judgment of any Provider.
I understand that Clinical Services are provided by independent licensed Providers, who may be affiliated with MD Integrations or who may be independent contractors of CodyMD.
I understand that no provider-patient relationship is created until a Provider reviews my case, accepts it, and initiates clinical care, and that no payment is captured before that point.
I understand that my Provider exercises independent professional judgment in all clinical decisions, may decline to provide treatment for any reason, and that no particular treatment, prescription, or diagnosis is guaranteed.
I understand that Clinical Services are currently available only to patients physically located in Oregon or Washington at the time of the encounter, and that I must be physically located in one of these states to receive Clinical Services.
I agree to provide accurate, current, and complete health information to my Provider, and to accurately disclose my physical location.
I agree to provide identity verification information as requested, including a valid government-issued photo ID.
I understand that all Clinical Services are provided on a self-pay (direct-pay) basis and that neither CodyMD nor my Provider will submit claims to insurance or other third-party payors.
I understand that my payment method will be authorized but not charged at the time of submission, and that I will be charged only if a Provider accepts my case.
I understand that my health information will be protected in accordance with HIPAA, the HITECH Act, applicable state law, and the CodyMD Privacy Policy.
I understand that CodyMD's AI-powered tools provide health information and education only, do not provide medical care, and that any medical advice, diagnosis, treatment, or prescription is made solely by my licensed Provider.
I understand that CodyMD does not provide mental, emotional, or behavioral health care services, and that I should seek appropriate resources (including 988) for any mental health concerns.
I have had the opportunity to ask questions about telehealth services and this Consent, and my questions have been answered to my satisfaction.
I understand that I may withdraw my consent to receive telehealth services at any time without affecting my right to future care.
I voluntarily consent to receive telehealth services through the CodyMD platform.
SIGNATURE BLOCK
Patient Name (Printed)
Patient Signature (or Electronic Acknowledgment)
Date
If this Consent is signed by a parent, guardian, conservator, or custodian on behalf of a minor or incapacitated individual:
Name of Parent/Guardian (Printed)
Signature of Parent/Guardian
Relationship to Patient
Date
Awesome Studios, LLC d/b/a CodyMD 2442 NW Westover Road, Suite 201, Portland, OR 97210 Support: help@cody.md | Privacy/HIPAA: privacy@cody.md | General: info@cody.md
Humans Served
Humans Served
CodyMD
CODYMD
Last Updated: April 30, 2026
This Telehealth Informed Consent ("Consent") provides you with important information about receiving healthcare services through telehealth technology via the CodyMD platform, operated by Awesome Studios, LLC d/b/a CodyMD ("CodyMD"). Please read this Consent carefully before receiving any Clinical Services through CodyMD.
CodyMD is a technology platform that facilitates your access to telehealth services provided by independent licensed healthcare providers ("Providers"). Providers may be affiliated with MD Integrations https://mdintegrations.com, an independent medical group with its own provider network with which CodyMD contracts to make clinical services available to patients, or may be independent contractor providers who deliver care directly through the CodyMD platform. CodyMD does not practice medicine, does not employ Providers for the purpose of delivering clinical care, and does not direct or control the independent clinical judgment of any Provider.
Clinical Services through CodyMD are currently available only to patients physically located in Oregon or Washington at the time of the clinical encounter. CodyMD's informational services (including AI-powered health education and information tools) are available more broadly, but no medical care, diagnosis, treatment, or prescription is provided through informational services.
Your consent to receive telehealth services is voluntary. You have the right to withdraw your consent at any time without affecting your right to future care or treatment, or your eligibility for benefits to which you would otherwise be entitled.
Telehealth is the delivery of healthcare services using electronic communications, information technology, and related technologies when you and your Provider are not in the same physical location.
The CodyMD telehealth model is principally asynchronous. This means:
You will provide information about your symptoms, medical history, and current medications through the CodyMD platform, including written responses, photographs where relevant, and other electronically transmitted information.
An independent licensed Provider will review the information you provide on a store-and-forward basis. The Provider does not need to be present at the same time you submit your information.
After review, your Provider will determine whether they are able to evaluate your condition and provide care via telehealth, whether additional information is needed, whether a synchronous (real-time) audio or video encounter is necessary, or whether your condition is not appropriate for telehealth and requires in-person evaluation.
A synchronous audio or video encounter may be initiated by your Provider at any time during the clinical encounter, in the Provider's professional judgment, when warranted by your clinical presentation or required by applicable state law. Your Provider will use a HIPAA-compliant audio or video platform for any synchronous encounter. You will be notified before any synchronous encounter and may decline.
In addition to the principal asynchronous workflow, telehealth services through the CodyMD platform may include:
Secure messaging between you and your Provider for follow-up questions, care coordination, and non-urgent communications.
Remote review of health data and laboratory results that you submit through the platform.
Electronic transmission of prescriptions to pharmacies of your choice.
Care coordination with other healthcare providers when authorized by you.
Clinical services through the CodyMD platform may include, within the scope of each Provider's licensure, primary care, urgent care, treatment of acute conditions, prescription management for established conditions, laboratory ordering and interpretation, and other services your Provider determines are appropriate for telehealth delivery.
Potential benefits of telehealth services through CodyMD include:
Increased access to healthcare for patients in areas with limited in-person provider availability.
Convenience of receiving evaluation and care from home or other private locations.
Reduced travel time and associated costs.
Timely access to licensed clinicians for non-emergency conditions.
Electronic access to your medical records, prescriptions, and Provider communications through the platform.
Asynchronous communication that does not require both you and your Provider to be present at the same time, which can facilitate care for patients with limited daytime availability.
You understand and acknowledge the following risks and limitations of telehealth, including those specific to asynchronous (store-and-forward) telehealth as practiced through CodyMD:
Telehealth is not appropriate for all medical conditions. Your Provider will determine whether telehealth is suitable for your specific situation.
Your Provider will not be able to perform a hands-on physical examination, which may limit the Provider's ability to diagnose or treat certain conditions.
Asynchronous review depends entirely on the accuracy and completeness of information you provide. Without the back-and-forth of a real-time encounter, the Provider may not be able to clarify ambiguous or incomplete information, which may lead to delays, requests for additional information, or recommendations to seek in-person care.
Your Provider may determine that telehealth is insufficient for your clinical needs and may recommend an in-person visit, referral to a specialist, or emergency care. You agree to follow such recommendations.
Delays in evaluation and treatment may occur due to the asynchronous nature of the workflow, technology limitations, or Provider availability.
There is a risk that your Provider's assessment may be limited or incorrect due to the inability to perform a physical examination, the inherent limitations of telehealth technology, or incomplete or inaccurate information provided by you.
Your Provider may decline to provide treatment in their sole professional discretion, including for clinical reasons, jurisdictional reasons, or other reasons. There is no guarantee that you will receive any particular treatment, prescription, or diagnosis.
Telehealth services depend on technology, including your internet connection, device, and software. Technology failures, interruptions, or poor connectivity may disrupt or prevent the delivery of services.
Despite reasonable security measures, there is a risk that electronic communications could be intercepted, corrupted, or otherwise compromised.
For asynchronous communications, there may be lower-quality images or insufficient information that affect your Provider's ability to evaluate your condition. Your Provider may request additional information or photographs.
For synchronous encounters where applicable, there may be audio or video quality issues that affect the encounter. Your Provider may attempt to reconnect, contact you by alternative means, or reschedule.
Although CodyMD implements administrative, physical, and technical safeguards in accordance with HIPAA to protect your health information, there are inherent risks to the transmission of information over the internet. Unauthorized access to your information is possible despite these safeguards. Please review our Privacy Policy at https://cody.md/privacy for detailed information about how we protect your data.
You are responsible for:
Ensuring that your telehealth interactions take place in a private location where others cannot overhear or view your information or any synchronous encounter.
Avoiding the use of public or shared computers or unsecured Wi-Fi networks for telehealth interactions.
Maintaining the confidentiality of your account credentials.
By consenting to receive telehealth services, you agree to the following:
You agree to provide accurate, current, and complete health information to your Provider, including your medical history, current medications, allergies, symptoms, and any other information relevant to your care. You understand that your Provider will rely on the accuracy and completeness of the information you provide, and that inaccurate or incomplete information may adversely affect your diagnosis and treatment. Providing knowingly false information may constitute fraud and may have legal consequences.
You must be physically located in Oregon or Washington at the time you receive Clinical Services through CodyMD. Your Provider must hold an active, unrestricted license in the state where you are physically located. You agree to accurately disclose your physical location at the time of each clinical encounter.
CodyMD uses geolocation, address verification, and government-issued identification verification to confirm your physical location and eligibility. Misrepresenting your location, identity, or eligibility may result in immediate termination of services without refund of any fees already captured, may void any clinical recommendations you have received, and may have legal consequences.
You agree to provide a valid, government-issued photo identification when requested by CodyMD. Identity verification is required for clinical services and is used to confirm that you are the patient receiving care, to verify your physical location, and to comply with applicable laws.
You are responsible for having a reliable internet connection and a device (computer, tablet, or smartphone) capable of accessing the CodyMD platform. For any synchronous encounters that may be initiated by your Provider, you are responsible for having functioning audio and video capabilities. CodyMD is not responsible for technology failures on your end.
You are responsible for ensuring that your interactions with CodyMD and your Provider take place in a private, secure environment where others cannot inadvertently see or hear your information or any synchronous encounter. If a third party will be present during a synchronous encounter, you should inform your Provider in advance.
You agree to follow your Provider's recommendations regarding follow-up care, including in-person visits, specialist referrals, laboratory testing, or emergency care when recommended. You understand that failure to follow recommended care may adversely affect your health outcomes, and that CodyMD and your Provider have no liability for outcomes resulting from your failure to follow recommended care.
THE CODYMD PLATFORM IS NOT DESIGNED FOR MEDICAL EMERGENCIES.
IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, STOP USING THE PLATFORM IMMEDIATELY AND CALL 911, GO TO YOUR NEAREST EMERGENCY ROOM, OR CALL YOUR LOCAL EMERGENCY SERVICES.
Examples of medical emergencies include, but are not limited to:
Chest pain or pressure
Difficulty breathing or shortness of breath
Severe bleeding or trauma
Loss of consciousness or fainting
Stroke symptoms (sudden numbness, confusion, difficulty speaking, severe headache, vision changes, or loss of balance)
Severe allergic reactions
Poisoning or overdose
Thoughts of harming yourself or others (see Section 11 for mental health crisis resources)
Severe abdominal pain
Pregnancy complications, including bleeding, severe pain, or contractions
Any condition requiring immediate medical attention
If you submit information through the CodyMD platform that indicates a medical emergency, the platform may automatically display emergency resource information. CodyMD's display of automated information in response to symptom keywords does not constitute medical evaluation. Always call 911 or go to an emergency room for medical emergencies, regardless of any automated response from the platform.
Your Provider may also determine during a clinical encounter that your condition requires emergency or in-person care and may direct you to seek such care immediately. You agree to follow such direction.
By receiving Clinical Services through the CodyMD platform, you establish a provider-patient relationship with the individual Provider who delivers your care. Providers may be affiliated with MD Integrations https://mdintegrations.com, an independent medical group with which CodyMD contracts to make clinical services available to CodyMD patients, or may be independent contractor Providers who deliver care directly through the CodyMD platform. The provider-patient relationship is between you and your individual Provider. CodyMD is not a party to this relationship and does not practice medicine.
The provider-patient relationship is established when, and only when, your Provider reviews your case, accepts the case, and initiates clinical care. Submitting information through the CodyMD platform, authorizing payment, or completing the intake process does not, by itself, create a provider-patient relationship. If your Provider declines to accept your case, no provider-patient relationship is created and no payment is captured (see Section 8).
Your Provider exercises independent professional judgment in all clinical decisions, including decisions about diagnosis, treatment, prescriptions, referrals, and whether telehealth is appropriate for your condition. CodyMD does not direct, control, or influence the clinical decisions of any Provider.
Your Provider may decline to provide treatment or may recommend alternative care, including in-person evaluation, at any time in the Provider's sole professional discretion. There is no guarantee that you will receive any particular treatment, prescription, or diagnosis.
If your Provider determines that a prescription medication is appropriate for your condition, your Provider may electronically transmit the prescription to a pharmacy of your choice or to a partnered pharmacy. You understand and agree to the following:
Your Provider has sole discretion over whether to prescribe any medication, including the type, dosage, and duration of any prescription. There is no guarantee that any particular prescription will be issued.
Certain medications, including most controlled substances, may not be prescribed via telehealth due to federal and state regulatory restrictions, the Ryan Haight Act, your Provider's clinical judgment, or other applicable rules.
You are responsible for informing your Provider of all medications you are currently taking, including over-the-counter medications, supplements, and herbal remedies, to avoid dangerous interactions.
You are responsible for following your Provider's instructions regarding prescribed medications and for promptly reporting any adverse reactions to your Provider or to your nearest emergency facility, as appropriate.
Pharmacy services are provided by independently owned and licensed pharmacies. CodyMD does not operate a pharmacy and is not responsible for the acts or omissions of any pharmacy.
All Clinical Services provided through the CodyMD platform are on a direct-pay (self-pay) basis only. CodyMD collects fees on behalf of Providers as an administrative service. Neither CodyMD nor any Provider will submit claims to health insurance plans, Medicare, Medicaid, HMOs, or any other third-party payor for Clinical Services rendered through the platform. If you wish to seek reimbursement from your insurer, you are solely responsible for submitting any claims, and reimbursement is not guaranteed.
When you request Clinical Services, CodyMD authorizes a payment hold on your selected payment method through Stripe but does not capture (charge) the payment at the time of authorization. Payment is captured only after a licensed Provider reviews your case and accepts it for treatment. If your Provider declines your case for any reason — including clinical reasons, jurisdictional ineligibility, lapsed Provider licensure, identity or address verification failure, or any other reason — the authorization is canceled and no payment is captured. You will not be charged for declined cases.
This means:
The amount displayed at the time of payment authorization is the amount you have authorized but have not yet been charged.
A pending authorization may temporarily appear on your card statement as a hold; this hold is released if your case is declined.
Your card or bank may show the authorization for several business days after a declined case before the hold is fully released; CodyMD has no control over how quickly the issuing institution releases authorizations.
Once payment is captured (i.e., after Provider acceptance and initiation of clinical care), the standard refund and dispute provisions in the Terms of Use apply.
Fees for Clinical Services are disclosed before you authorize payment. By proceeding, you agree to pay the disclosed fees if and when your case is accepted by a Provider.
Your telehealth encounter and associated health information are protected by federal and state privacy laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), the HITECH Act, and applicable state privacy laws (including the Washington My Health My Data Act for Washington residents).
CodyMD operates as a Business Associate under HIPAA with respect to Protected Health Information (PHI) handled on behalf of Providers and contracted medical groups, including MD Integrations. CodyMD maintains Business Associate Agreements as required by HIPAA and implements administrative, physical, and technical safeguards to protect the confidentiality, integrity, and availability of your PHI. Detailed information about CodyMD's privacy and HIPAA practices is available in the Privacy Policy and HIPAA Notice of Privacy Practices at https://cody.md/privacy.
CodyMD uses third-party identity verification services to confirm your identity before clinical services are provided. As part of identity verification, you may be asked to upload a government-issued photo identification and to provide other identifying information. Identity verification information is used to confirm that you are the patient receiving care, to verify your physical location, to support prescription workflows, and to comply with applicable laws. Identity verification information is handled in accordance with the Privacy Policy.
Your Provider will create and maintain medical records of your telehealth encounters in accordance with applicable law. CodyMD stores medical records on HIPAA-compliant infrastructure for a minimum of seven (7) years from the date of the last encounter, or longer where required by state law. Your rights regarding access to, amendment of, accounting of disclosures from, and other actions related to your medical records are described in the HIPAA Notice of Privacy Practices.
You agree not to record (audio, video, or otherwise) any telehealth encounter without the prior written consent of your Provider. CodyMD and your Provider will not record encounters without your prior consent, except as required for clinical documentation purposes consistent with applicable law and Provider professional obligations.
CodyMD operates AI-powered tools (the "AI Tools") that provide general health information and education. The AI Tools do not provide medical advice, diagnosis, treatment, or prescription. The AI Tools do not establish a patient-provider relationship. Any clinical care, including all medical advice, diagnosis, treatment, and prescriptions, is provided exclusively by independent licensed Providers as described in this Consent and the Terms of Use.
The AI Tools may discuss general information about symptoms, conditions, medications, and health topics. The AI Tools may help you prepare to discuss your health with a clinician. The AI Tools do not replace evaluation by a licensed clinician.
The AI Tools are imperfect and may produce information that is incomplete, outdated, or incorrect. You acknowledge that:
Information provided by the AI Tools must not be relied upon as medical advice.
Any decision regarding your health should be made in consultation with a licensed clinician.
Failure to seek timely care from a licensed clinician based on information from the AI Tools may result in serious harm, for which CodyMD bears no liability.
You will not use the AI Tools as your sole source of health information and will not make significant health decisions based solely on AI Tool output.
Conversations you have with the AI Tools are stored by CodyMD as described in the Privacy Policy. CodyMD does not use individually identifiable user conversations to train third-party AI models. [NOTE TO COUNSEL: Confirm with internal AI/engineering team. If CodyMD does train its own internal models on user conversations after de-identification, this language should be made specific. The current draft is conservative.]
When you transition from the AI Tools to Clinical Services, your Provider may review information you have shared with the AI Tools as part of your clinical encounter. Your Provider exercises independent professional judgment in any clinical decision and is not bound by AI Tool output.
CodyMD does not provide mental, emotional, or behavioral health care services. You agree not to use Clinical Services for any mental, emotional, or behavioral health concerns, including but not limited to:
Depression, anxiety, or other mood disorders
Suicidal thoughts, self-harm, or thoughts of harming others
Substance use disorders
Eating disorders
Psychiatric conditions or psychiatric crises
Other mental, emotional, or behavioral health conditions
If you are experiencing a mental health crisis, please contact the 988 Suicide and Crisis Lifeline by calling or texting 988, contact the Crisis Text Line by texting HOME to 741741, or call 911 or go to your nearest emergency room.
If you are seeking ongoing mental or behavioral health care, please consult directly with a licensed mental health professional in your jurisdiction. CodyMD's AI Tools may automatically detect certain mental or behavioral health-related queries and direct you to appropriate resources; this is not a substitute for evaluation by a licensed mental health professional.
CodyMD implements multiple safeguards to ensure that Clinical Services are provided only to eligible patients in jurisdictions where CodyMD's contracted Providers are licensed:
Geolocation. At the time of clinical service request, CodyMD uses geolocation technology to determine your approximate physical location.
Patient Self-Declaration. You are required to disclose your physical location at the time of clinical service request.
Identity Verification. You are required to provide a valid government-issued photo identification, which is verified against your self-disclosed information.
Address Verification. Your delivery address (where applicable, for prescriptions or other physical fulfillment) is verified against your identification and other information.
Provider Licensure Monitoring. CodyMD and MD Integrations monitor Provider licensure status on an ongoing basis. A Provider with a lapsed, suspended, or revoked license may not accept cases through the platform.
Payment Hold. As described in Section 8, payment is authorized but not captured until a Provider accepts your case. If any of the above verification steps fails — including jurisdictional ineligibility, identity verification failure, or Provider licensure issues — your case is declined and no payment is captured.
These safeguards operate together to prevent payment from, and Clinical Services to, jurisdictions where CodyMD does not operate or where the assigned Provider is not licensed.
As a patient receiving telehealth services through the CodyMD platform, you have the right to:
Withdraw your consent to receive telehealth services at any time without affecting your right to future care or your eligibility for benefits.
Refuse any proposed treatment and be informed of the consequences of such refusal.
Request an in-person visit or referral to an in-person provider at any time, recognizing that CodyMD does not directly provide in-person care.
Decline a synchronous (real-time audio or video) encounter if your Provider proposes one, recognizing that this may affect your Provider's ability to evaluate your condition.
Access your medical records in accordance with applicable law.
Request amendments to your medical records.
Request an accounting of disclosures of your PHI.
Receive information about the identity, qualifications, and licensure of your Provider.
Receive a copy of this Consent.
File a complaint about your care, the privacy of your health information, or any other aspect of your experience, as described in the Privacy Policy and HIPAA Notice of Privacy Practices. CodyMD will not retaliate against you for filing a complaint.
Be treated with respect and dignity regardless of race, ethnicity, national origin, religion, gender, sexual orientation, age, disability, or other protected characteristic.
Clinical Services through CodyMD are currently available only to patients physically located in Oregon or Washington at the time of the clinical encounter. Clinical Services are not available in any other state or territory at this time. CodyMD's informational services are available more broadly but do not constitute medical care.
If CodyMD expands clinical services to additional jurisdictions in the future, this Consent will be updated to reflect the additional state-specific provisions, and patients in those new jurisdictions will be required to acknowledge the updated Consent before receiving services.
For patients in Oregon, the following additional provisions apply:
Your Provider is licensed in Oregon by the Oregon Medical Board or the applicable licensing authority for the Provider's profession.
Your Provider will exercise the same standard of care via telehealth that would apply to in-person services in Oregon.
Your Provider will comply with all applicable Oregon laws and regulations regarding telehealth, including those of the Oregon Medical Board, the Oregon State Board of Pharmacy with respect to prescriptions, and any other applicable regulatory body.
You have the right to receive a copy of your medical records, request corrections, and receive an explanation of your diagnosis and treatment in accordance with Oregon law.
You may file complaints regarding the care you receive with the Oregon Medical Board or other applicable Oregon licensing authority.
For patients in Washington, the following additional provisions apply:
Your Provider is licensed in Washington by the Washington Medical Commission or the applicable licensing authority for the Provider's profession.
Your Provider will comply with all applicable Washington telehealth regulations, including those of the Washington Medical Commission and the Washington State Department of Health.
You have the right to be informed of your Provider's qualifications, licensure status, and the location from which they are providing services, and may request this information at any time.
You may request an in-person visit at any time, recognizing that CodyMD does not directly provide in-person care.
Your consumer health data is also protected under the Washington My Health My Data Act, and you have additional rights regarding your consumer health data as described in the Privacy Policy.
You may file complaints regarding the care you receive with the Washington Medical Commission or other applicable Washington licensing authority.
You understand that CodyMD is a technology platform that facilitates your access to telehealth services. CodyMD is not liable for the clinical decisions, acts, or omissions of any Provider, MD Integrations, or any pharmacy. The provider-patient relationship, when established, is between you and your Provider, and your Provider is solely responsible for the clinical care you receive.
CodyMD is not liable for any loss, injury, or damage resulting from technology failures, internet service interruptions, or other circumstances beyond CodyMD's reasonable control that affect the delivery of telehealth services.
Additional limitations of liability are set forth in the CodyMD Terms of Use, available at https://cody.md/terms, which are incorporated by reference into this Consent.
By electronically signing this Consent (e.g., by checking the "I agree" box on the CodyMD platform) or by signing below, I acknowledge and agree that:
I have read (or have had the opportunity to read) and understand this Telehealth Informed Consent.
I understand what telehealth is, including its potential benefits, risks, and limitations as described above, and specifically that CodyMD's principal model is asynchronous (store-and-forward) review with synchronous escalation at the Provider's discretion.
I understand that telehealth is not appropriate for all medical conditions and that my Provider may recommend in-person care.
I understand that the CodyMD platform is not designed for medical emergencies and that I should call 911 or go to an emergency room in the event of a medical emergency.
I understand that CodyMD is a technology platform and does not practice medicine or direct the clinical judgment of any Provider.
I understand that Clinical Services are provided by independent licensed Providers, who may be affiliated with MD Integrations or who may be independent contractors of CodyMD.
I understand that no provider-patient relationship is created until a Provider reviews my case, accepts it, and initiates clinical care, and that no payment is captured before that point.
I understand that my Provider exercises independent professional judgment in all clinical decisions, may decline to provide treatment for any reason, and that no particular treatment, prescription, or diagnosis is guaranteed.
I understand that Clinical Services are currently available only to patients physically located in Oregon or Washington at the time of the encounter, and that I must be physically located in one of these states to receive Clinical Services.
I agree to provide accurate, current, and complete health information to my Provider, and to accurately disclose my physical location.
I agree to provide identity verification information as requested, including a valid government-issued photo ID.
I understand that all Clinical Services are provided on a self-pay (direct-pay) basis and that neither CodyMD nor my Provider will submit claims to insurance or other third-party payors.
I understand that my payment method will be authorized but not charged at the time of submission, and that I will be charged only if a Provider accepts my case.
I understand that my health information will be protected in accordance with HIPAA, the HITECH Act, applicable state law, and the CodyMD Privacy Policy.
I understand that CodyMD's AI-powered tools provide health information and education only, do not provide medical care, and that any medical advice, diagnosis, treatment, or prescription is made solely by my licensed Provider.
I understand that CodyMD does not provide mental, emotional, or behavioral health care services, and that I should seek appropriate resources (including 988) for any mental health concerns.
I have had the opportunity to ask questions about telehealth services and this Consent, and my questions have been answered to my satisfaction.
I understand that I may withdraw my consent to receive telehealth services at any time without affecting my right to future care.
I voluntarily consent to receive telehealth services through the CodyMD platform.
SIGNATURE BLOCK
Patient Name (Printed)
Patient Signature (or Electronic Acknowledgment)
Date
If this Consent is signed by a parent, guardian, conservator, or custodian on behalf of a minor or incapacitated individual:
Name of Parent/Guardian (Printed)
Signature of Parent/Guardian
Relationship to Patient
Date
Awesome Studios, LLC d/b/a CodyMD 2442 NW Westover Road, Suite 201, Portland, OR 97210 Support: help@cody.md | Privacy/HIPAA: privacy@cody.md | General: info@cody.md