Informed Consent to Telehealth Services and Muber’s Policies
This form describes Muber’s platform services and payment policies and includes:
-
Your consent to receive medical treatment over Muber from independent health care
providers (doctors) (and your other rights and responsibilities with respect to receiving
such treatment);
- Your agreement to receive services using telehealth technology; and
-
Your agreement to pay in full any charges for availing services over Muber that are
your responsibility.
By typing my name and clicking “I agree to Terms of Use” on the Muber telehealth portal, I
understand and agree that I am signing this Consent electronically and that (i) I have reviewed,
understand and accept the risks and benefits of telehealth services as described below and
wish to receive such services, and (ii) I agree to the remaining terms of this Consent Form,
including the terms of the Muber Privacy Notice described below.
If I am signing on behalf of a minor, incapacitated or otherwise legally dependent patient, I
certify that I am a person with legal authority to act on behalf of the patient, including the
authority to consent to medical services, and I accept financial responsibility for services
rendered.
-
1. Muber’s services are provided through www.muber.global, Muber Android and iOS
Apps, which is a tele-health online solution that allows participating medical
professionals and health care staff (“Healthcare Providers” or “Providers”) to
communicate with their clients and patients (“Patients”) to provide health care
services online and perform virtual house calls via a secure Internet connection
(the “Services”). Muber is not a medical service provider, health insurance
company, or licensed to sell health insurance. Muber does not provide any
warranty with regard to the qualifications, licenses or certification of the Providers.
Muber will not be responsible for any claim, controversy or issue arising out of the
aforesaid Services. I agree that Muber is only responsible for the delivery of the
Services through the Site and the health care providers are independent of Muber.
-
2. Muber does not provide any warranty with regard to the qualifications, licenses or
certification of the Providers
-
3. The term “Site” includes the website, web Portal, mobile applications and such
other software designed by Muber for the purpose of delivery of the Services,
accessed from time to time through the use of any technology (including computer
devices, tablets, phones etc.)
-
4. The terms “health care provider”, “medical service provider” and “provider” are
used interchangeably and is defined as the practicing medical doctor who has
expertise in his or her stated areas of medicine.
-
5. By using the Muber telehealth portal, I agree to receive telehealth services.
Telehealth involves the delivery of health care services, including assessment,
treatment, diagnosis, and education, using interactive audio, video, and data
communications. During my visit, my health care provider and I will be able to see
and speak with each other from remote locations and any query or health-related
complication shall be directly referred to my health care provider. I agree that
Muber is only responsible for ‘delivering’ healthcare services, and accepts no
responsibility or liability for the soundness of the health care Services rendered.
-
6. I understand and agree that:
- I will not be in the same location or room as my medical provider.
-
My health care provider is licensed in the city/country/state in which I am
receiving services. I will report my location accurately during registration with
Muber.
-
Potential benefits of telehealth (which are not guaranteed or assured) include:
(i) access to medical care if I am unable to travel to my Muber service provider’s
office; (ii) more efficient medical evaluation and management; and (iii) during
the COVID-19 pandemic, reduced exposure to patients, medical staff and other
individuals at a physical location.
-
Potential risks of telehealth include: (i) limited or no availability of diagnostic
laboratory, x-ray, EKG, and other testing, and some prescriptions, to assist my
medical provider in diagnosis and treatment; (ii) my provider’s inability to
conduct a hands-on physical examination of me and my condition; and (iii)
delays in evaluation and treatment due to technical difficulties or interruptions,
distortion of diagnostic images or specimens resulting from electronic
transmission issues, unauthorized access to my information, or loss of
information due to technical failures. I will not hold Muber responsible for lost
information due to technological failures or for unauthorized access to my
information.
-
I further understand that my health care provider’s advice, recommendations,
and/or decisions may be based on factors not within his/her control, including
incomplete or inaccurate data provided by me. I understand that my Health
care provider relies on information provided by me before and during our
telehealth encounter and that I must provide information about my medical
history, condition(s), and current or previous medical care that is complete and
accurate to the best of my ability. I understand that Muber does not take any
responsibility for the services provided to me by my health care providers.
-
I may discuss these risks and benefits with my health care provider and will
be given an opportunity to ask questions about telehealth services. I have the
right to withdraw this consent to telehealth services or end the telehealth
session at any time without affecting my right to future treatment by the health
care provider.
-
I understand that the level of care provided by my health care provider is to be
the same level of care that is available to me through an in-person medical visit.
However, if my provider believes I would be better served by face-to-face
services or another form of care, I will be referred to the nearest medical center,
hospital emergency department or other appropriate health care service
provider. And I will have no objection to it.
-
I have the right to receive, at my own cost face-to-face medical services at any
time by traveling to a medical center that is convenient to me.
-
In case of an emergency, I will dial emergency number of the state/city/country
I am residing in at the time or go directly to the nearest hospital emergency
room. I understand that Muber does not take any responsibility to respond or
connect me to any provider in emergency, and I will not hold Muber responsible
in such a scenario. I absolve Muber from any liability arising out of the same.
-
7. I consent to, understand and agree that:
-
I have the right to discuss the risks and benefits of all procedures and courses
of treatment proposed by my health care provider(s), together with any
available alternatives.
-
Health care provider will provide care consistent with the prevailing standards
of medical practice but makes no assurances or guarantees as to the results
of treatment.
-
I have the right to review and receive copies of my medical records, including
all information obtained during a telehealth interaction, subject to Muber’s
standard policies regarding request and receipt of medical records and
applicable law.
-
The laws of the city/province/state/country in which I am located will apply to
my receipt of telehealth services.