Telehealth Informed Consent

This Telehealth Informed Consent ("Consent") is provided by Open Water Rx LLC ("Open Water Rx") to inform you about the nature of telehealth services, the risks and benefits associated with telehealth, and your rights as a patient. By submitting a health evaluation through our platform and proceeding with our Services, you acknowledge that you have read, understood, and consent to the terms described herein.

Telehealth involves the use of electronic communications, including the internet, video conferencing, telephone, and secure messaging, to enable healthcare providers to evaluate, diagnose, consult, treat, and monitor patients remotely. Open Water Rx facilitates telehealth consultations between patients and independently licensed physicians for the purpose of evaluating eligibility for GLP-1 weight management therapy.

You understand and acknowledge the following regarding telehealth services provided through Open Water Rx:

Telehealth services are not a substitute for in-person medical care in all circumstances - The physician reviewing your evaluation will not conduct a physical examination - The physician's assessment is based solely on the information you provide in your health evaluation form and any follow-up communications - The quality of the telehealth service may be affected by technical failures, internet connectivity issues, or equipment malfunctions - In the event of a technical failure, your evaluation may be delayed or rescheduled - Telehealth services may not be appropriate for all medical conditions or emergencies

IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, DO NOT USE THIS PLATFORM. CALL 911 OR GO TO YOUR NEAREST EMERGENCY ROOM IMMEDIATELY.

You acknowledge that telehealth services carry certain risks, including but not limited to:

Delays in evaluation and treatment due to technical failures or communication limitations - Potential for incomplete or inaccurate assessment due to the absence of a physical examination - Potential for misdiagnosis or inappropriate treatment recommendations based on incomplete information - Security risks associated with electronic transmission of health information, despite our security measures - Potential for technical disruptions that may interrupt or prevent delivery of services - Limitations in the physician's ability to assess your condition without direct physical contact

You understand that these risks exist and that you voluntarily accept them in exchange for the convenience and accessibility of telehealth services.

Telehealth services offer significant benefits, including:

Convenient access to licensed healthcare providers without the need for in-person visits - Elimination of travel time and associated costs - Access to care from the comfort and privacy of your home - Reduced exposure to communicable diseases in clinical settings - Faster access to evaluation and treatment for appropriate conditions - Continuity of care for ongoing treatment and monitoring - Access to specialized care that may not be locally available

To ensure the safety and effectiveness of your telehealth care, you agree to:

Provide complete, accurate, and truthful information in your health evaluation, including all current medications, medical history, allergies, and health conditions - Disclose any information that may affect your eligibility for or safety with GLP-1 therapy - Notify your physician immediately of any adverse reactions, side effects, or changes in your health condition - Follow all instructions provided by your prescribing physician - Maintain regular follow-up as recommended by your care team - Seek in-person emergency care immediately if you experience a medical emergency - Not share, sell, or transfer any prescription medications to another person - Inform your primary care physician and other treating providers of any medications prescribed through Open Water Rx

You acknowledge that providing false or misleading health information may result in inappropriate treatment and could cause serious harm. Open Water Rx and its affiliated physicians are not liable for adverse outcomes resulting from inaccurate information you provide.

You understand and acknowledge that:

No prescription is guaranteed as a result of your evaluation - All prescribing decisions are made at the sole clinical discretion of the licensed physician reviewing your case - The physician may decline to prescribe if they determine that GLP-1 therapy is not clinically appropriate for you - The physician may request additional information, laboratory results, or documentation before making a prescribing decision - Prescriptions issued through our platform are valid only for the specific patient and condition for which they are prescribed - Medications prescribed through our platform are intended to be used as part of a comprehensive weight management program that includes dietary and lifestyle modifications

Your health information shared through our telehealth platform is protected under the Health Insurance Portability and Accountability Act (HIPAA) and applicable state privacy laws. We implement technical, administrative, and physical safeguards to protect the confidentiality and security of your health information.

You acknowledge that, despite these safeguards, the transmission of health information over the internet carries inherent security risks. We cannot guarantee absolute security of electronically transmitted information. By consenting to telehealth services, you accept these risks.

Your health information will not be shared with third parties except as described in our HIPAA Notice of Privacy Practices and Privacy Policy, or as required by law.

Telehealth services are subject to the laws and regulations of the state in which you are located at the time of your evaluation. Open Water Rx currently provides services in Florida and select other states. By using our Services, you represent that you are located in a state where our Services are available.

The prescribing physician must be licensed in the state where you are located at the time of the consultation. If you relocate to a state where our Services are not available, you may lose access to ongoing care through our platform. We will make reasonable efforts to notify you of any changes in service availability.

You have the right to withdraw your consent to telehealth services at any time, without penalty or loss of access to alternative care. Withdrawal of consent will not affect any care already provided. To withdraw consent, please contact us at info@openwaterrx.com.

Withdrawal of consent may result in discontinuation of your telehealth services through Open Water Rx. We encourage you to discuss any concerns about telehealth services with your care team before withdrawing consent.

Open Water Rx and its affiliated healthcare providers make no representations or warranties regarding the outcomes of telehealth services or GLP-1 therapy. Individual results vary based on medical history, adherence to treatment, lifestyle factors, and other variables beyond our control.

Statements on our website regarding weight loss outcomes are for informational purposes only and do not constitute a guarantee of results. GLP-1 medications are prescription drugs with potential side effects and contraindications. You acknowledge that you have been informed of the potential risks and benefits and that you are voluntarily choosing to pursue this treatment.

Telehealth services are not appropriate for medical emergencies. If you experience any of the following, seek immediate emergency care by calling 911 or going to your nearest emergency room:

Chest pain or pressure - Difficulty breathing or shortness of breath - Signs of stroke (sudden numbness, confusion, vision changes, severe headache) - Severe allergic reaction (anaphylaxis) - Severe abdominal pain - Thoughts of self-harm or suicide - Any other life-threatening condition

For non-emergency medical questions or concerns related to your prescription, contact your care team through the patient portal or at info@openwaterrx.com.

By proceeding with your health evaluation and using our Services, you acknowledge that:

You have read and understood this Telehealth Informed Consent in its entirety - You have had the opportunity to ask questions and have them answered to your satisfaction - You voluntarily consent to receive telehealth services through Open Water Rx - You understand the risks, benefits, and limitations of telehealth services - You agree to provide accurate and complete health information - You understand that no physician-patient relationship is established until a licensed physician accepts your case

This Consent is effective as of April 4, 2026, and applies to all telehealth services you receive through Open Water Rx. We reserve the right to update this Consent at any time. Continued use of our Services constitutes acceptance of any updated Consent.