Telehealth Consent

Last updated: August 25, 2026

Clinical services provided by Beluga Health

This Telehealth Consent Form explains the nature of the telehealth services provided through the DissolvdRX platform, your rights as a patient, and the limitations and risks associated with receiving care via telehealth. Please read this document carefully. By submitting your health intake, you confirm that you have read, understood, and agreed to the terms of this consent.

Medical Emergency Notice

If you are experiencing a medical emergency, call 911 or go to your nearest emergency room immediately. This platform is not monitored for emergencies and is not appropriate for urgent medical care.

Nature of Telehealth Services

What Is Telehealth?

Telehealth refers to the delivery of healthcare services using electronic communications, information technology, or other means between a licensed healthcare provider and a patient who are not in the same physical location. DissolvdRX facilitates telehealth consultations by connecting you with licensed physicians through Beluga Health, a licensed telehealth medical group.

These services are provided asynchronously — meaning your health intake is reviewed by a licensed physician at a time that may differ from when you submitted it, and communication occurs through our secure platform rather than a live video call. You are not required to attend a live appointment; your intake questionnaire serves as the basis for the physician’s clinical evaluation.

Services Provided Through Telehealth

Through the DissolvdRX platform, a licensed physician through Beluga Health may:

Review your health history and intake questionnaire
Evaluate your suitability for treatment with Sildenafil, Tadalafil, or The Blend (Sildenafil + Tadalafil combination)
Issue a prescription for an appropriate treatment if clinically indicated
Provide follow-up clinical communications regarding your care

DissolvdRX does not provide emergency medical care, primary care, or ongoing chronic disease management through this platform.

Your Rights as a Telehealth Patient

Right to Informed Consent

You have the right to be informed about the nature of the telehealth services being provided, including the technology being used, potential risks and limitations, and your options for in-person care. By submitting this consent, you confirm that you have been provided with this information.

Right to Refuse or Withdraw Consent

Your consent to telehealth services is entirely voluntary. You have the right to refuse to participate in telehealth services or to withdraw your consent at any time without affecting your right to future care or treatment. If you withdraw consent, we will discuss alternative means of accessing care if appropriate.

Right to Expect Privacy

All electronic communications and health information transmitted through our platform are encrypted and protected. Your health information will not be disclosed to third parties without your consent, except as required by law or as necessary for your clinical care (e.g., the dispensing pharmacy).

Right to In-Person Care

You retain the right at all times to seek in-person medical care for any condition, including conditions for which you are receiving telehealth services through DissolvdRX. Telehealth services are not a substitute for in-person care in all situations, and your provider may recommend in-person evaluation if clinically appropriate.

Right to Access Records

You have the right to request copies of your health intake, any physician notes, and your prescription records. Submit requests to hello@dissolvdrx.com or call 800-269-2889.

Risks & Limitations of Telehealth

Limitations Compared to In-Person Care

Telehealth services have inherent limitations compared to in-person medical care. The reviewing physician evaluates you based solely on the information you provide in your health intake. The physician cannot perform a physical examination, observe clinical signs directly, or run laboratory tests as part of this consultation.

It is critical that you provide complete and accurate information in your health intake. Inaccurate or incomplete health information may result in a prescription being issued that is not appropriate for your medical situation, which could pose a risk to your health.

Technology Risks

As with any technology platform, there is a risk of technical failure, data breach, or interruption of service. While we employ industry-standard security measures, no system is entirely immune to these risks. In the event of a technical failure that interrupts your care, we will make reasonable efforts to restore service and communicate with affected patients.

When to Seek In-Person Care

You should seek immediate in-person medical care or call 911 if you experience:

Chest pain, irregular heartbeat, or difficulty breathing
Sudden severe headache, vision changes, or dizziness
Symptoms of a serious allergic reaction (swelling, difficulty swallowing, rash)
An erection lasting more than 4 hours (priapism) — this is a medical emergency requiring immediate treatment
Any other medical emergency

Telehealth services through DissolvdRX are NOT appropriate for emergencies. Do not use this platform for urgent or emergency medical care.

Consent Declaration

By Proceeding, You Acknowledge and Agree

By submitting your health intake through the DissolvdRX platform, you acknowledge and agree that:

You have read and understand this Telehealth Consent form in its entirety
You voluntarily consent to receive telehealth medical services through the DissolvdRX platform facilitated by Beluga Health and its affiliated licensed physicians
You understand that telehealth services are provided asynchronously and do not involve a live video consultation
You understand that the reviewing physician will rely solely on the information you provide in your health intake to make clinical decisions
You confirm that all information provided in your health intake is accurate and complete to the best of your knowledge
You understand that a prescription is not guaranteed and is issued solely at the physician's discretion
You have been informed of the risks, benefits, and alternatives to telehealth services, including the option to seek in-person care
You are 18 years of age or older and legally able to consent to medical treatment
You understand that all sales of dispensed prescription medications are final, per our Refund Policy
You authorize the reviewing physician to share necessary clinical information with the dispensing pharmacy for the purpose of fulfilling your prescription

State-Specific Limitations

Telehealth services and the prescribing of medications via telehealth are subject to applicable state laws. Treatment may not be available in all U.S. states. By proceeding, you confirm that you are located in a state where DissolvdRX services are available. Service availability is confirmed during the intake process.

Clinical Provider Disclosure

All clinical evaluations, physician consultations, and prescribing decisions are performed by licensed physicians affiliated with Beluga Health, a licensed telehealth medical group. DissolvdRX LLC is a technology platform and is not a medical provider, physician group, or pharmacy. The physician-patient relationship, if any, is between you and the Beluga Health-affiliated physician who reviews your case.

If you have questions about this Telehealth Consent or would like to speak with someone before proceeding:

Sildenafil

Tadalafil

The Blend