Informed Consent

Informed Consent for Telehealth Services. Effective Date: March 2, 2026.

Accessing healthcare can sometimes be cumbersome, involving travel and significant related time commitments. Zest Health offers you a new way to connect with a Citrus health care provider. Instead of going to an office, you can get health care services through electronic communications – like using your smart phone, tablet or computer. We call this “telehealth”. In this form, we will call your telehealth care provider your “Treating Provider”.

Before you agree to interact with your Treating Provider on a Zest Health telehealth platform, we want to make sure you understand how telehealth generally works and that you appreciate the primary risks and benefits. This consent form, together with the remainder of the Zest Terms and Policies (which are incorporated here by this reference), explains these things and provides other important information.  As with the remainder of the Zest Terms and Policies, please read this consent section carefully and check the associated box to confirm you understand and accept all of Zest’s Terms and Policies, including these terms of consent. 

Please also note that your Treating Provider may discuss additional elements of patient consent with you, including a discussion of the risks and benefits of telehealth and/or treatment that may be unique to you or your circumstances. These terms of Informed Consent are intended to supplement any additional elements of patient consent obtained and/or discussed with you by your Treating Provider. 

Your Treating Provider:

Zest Health is not a health care provider – Zest Health helps you and your Treating Provider by providing the telehealth technology for visits and doing things like scheduling and billing.

You will have the opportunity to pick the Treating Provider that you want. Or, you can ask us to pick someone. Your Treating Provider’s license, experience and credentials are available to you and you can always ask questions if you need help. Your Treating Provider is part of a health care services company including Citrus Dermatology Services of MD, P.C. ("Citrus MD"), Citrus Dermatology Services of NY, P.C. ("Citrus NY"), or Citrus Dermatology Services of NJ, P.C. (“Citrus NJ”), and the professional medical groups which render services to you within the Citrus network (collectively, the "Citrus").  Citrus and your Treating Provider are therefore “independent contractors.”  They are not employed, controlled, or directed by Zest.  In coordination with the provision of Treatment to you, your Treating Provider may consult other providers, such as a rheumatologist, to guide treatment options. These consults, if completed, will not incur any additional financial liability. 

Telehealth Connections:

You will not be in the same room as your Treating Provider. You might not even be in the same state. This means information is shared back and forth using technology. Depending on the nature of your condition and the professional services provided to you, your Treating Provider may elect to use one or more of the following ways to connect with you, share information, and help you with a care plan.

Real-Time “Live” Visits:

You may connect with your Treating Provider in “real time” through your phone, tablet, or computer. You may just hear each other’s voices, or see and hear each other on video.

Messaging:

You may send and receive messages to and from your Treating Provider. This may be text, e-mail, voicemail, online chatting, or even regular mail. The messages may include text, pictures, audio messages, or video messages.

“Store and Forward” Interactions:

Your Treating Provider may ask other health care providers for advice. That means your Treating Provider may send your information to other health care providers – including providers who are not in your state.

Appointments & Monitoring:

You can use the online system to schedule a time to meet with your Treating Provider. Remote monitoring such as asynchronous clinical assessments may be sent to support your care.

Prescriptions:

Your Treating Provider may help you manage your medications by sending a prescription, giving you a reminder, or offering information about your medicines.

Your Care Plan:

You can access information about your care plan, including things like test results. Your Treating Provider can also give you educational information so you can learn more.

Information About You:

The types of information you will share with your Treating Provider through telehealth is a lot like the information you give a doctor who you see in person. You may be asked to provide things like your: medical history, social history and habits, current medications, test results, imaging results (like x-rays), past medical records, descriptions of your problems and symptoms, or pictures of you.

Your Treating Provider needs correct information about you in order to assess you, understand your concerns, consult with other providers, make recommendations for your care, and educate you about your health. You can log in and update your information any time. By signing at the end of this form, you agree that your Treating Provider (and Zest Health acting on behalf of your Treating Provider) can get copies of your medical records from your other health care providers either directly or by accessing a health information exchange.

Your Care Plan:

Your Treating Provider will set up a care plan that focuses on you and will explain the Treating Provider’s findings, diagnosis, treatment recommendations, pros and cons of treatment recommendations, and alternative treatments. Just like when you see a doctor in person, your Treating Provider cannot promise you that you will get better. But, your Treating Provider will meet the “standard of care” and follow the same laws that in-person health care providers follow.

If it is necessary for you to see someone in person or meet with a specialist, your Treating Provider will let you know. Sometimes this is called a “referral”. Your Treating Provider will use telehealth to help you ONLY when the Treating Provider thinks it is okay. If you need to see someone in-person, your Treating Provider will not agree to treat you through telehealth.

Your Prescriptions:

Just like when you see an in-person doctor, there is no guarantee that your treating Provider will send you a prescription. This will only happen if your Treating Provider, based upon an appropriate examination of you, determines it is medically appropriate to provide you with a prescription medication. You can decide to fill your prescription at any pharmacy you think is best for you.

You Still Need Your Primary Doctor:

The biggest difference between in-person visits and telehealth is that there is no physical touching. Telehealth is terrific for certain questions and problems – but you still need a doctor that you can see in person. Your primary care physician is responsible for taking care of your overall health and well-being. Your Treating Providers will help supplement that care. If you do not have a primary care physician, we strongly encourage you to locate one near you. Your Treating Provider will let you know when you should see someone in person.

Your Privacy & Security:

In addition to the provisions contained in the Notice of Privacy Practices, which is made a part of these Zest Terms and Conditions, please be aware that it is your responsibility to ensure that you are in an appropriately private , secure, and uninterrupted environment when receiving telehealth services. Conversely, depending on the physical location of your Treating Provider, other health care professionals and/or support personnel may be physically present with and/or near your Treating Provider when the telehealth services are provided to you. Please also understand that your Treating Provider may be required to confirm your identity, age, and physical location when receiving the telehealth service. Your Treating Provider may determine it necessary to conclude, or otherwise to not provide, a telehealth service depending upon your responses. 

Benefits:

There are many ways that telehealth services are potentially helpful to you and the health care providers who care about you. You can stay at home and still get the help you need. Even if you do not live near a specialist, you can still access care. You do not have to make an appointment just to share information or get advice from your Treating Provider – you can quickly connect through telehealth. Also, it may be much easier for health care providers to share information with each other – and with you.

Risks:

There are risks associated with telehealth.  By their remote nature, telehealth services may be limited in scope. It is important that you communicate to your Treating Provider, to the extent possible, any known medical problems, history, or symptoms that you have experienced or are experiencing. It is also important that you ask your Treating Provider any questions you may have regarding your condition or the telehealth services being provided. Your failure to do so may adversely impact or negate your Treating Provider’s ability to effectively provide the telehealth services. Additionally, not all professional medical services may be provided through telehealth. As noted above, your Treating Provider may determine, in his/her discretion, not to render a diagnosis or treatment, or not to proceed with a telehealth service. Instead, your Treating Provider may recommend that you be seen in-person or that other appropriate measures be taken. As noted elsewhere in the Terms and Conditions, given that technology is being used to facilitate the telehealth services, sudden interruptions, delays, poor image quality, termination of connection, or other technical difficulties or limitations may occur. In the event of unexpected technical difficulties, the telehealth services may terminate unexpectedly and the examination/encounter between you and your Treating Provider may not occur or may remain incomplete. While this does not happen often, if it does occur, we may need to reschedule your appointment or find another way to connect with you. This could cause a delay in your assessment or treatment. Again, should you have any questions or concerns about this information, or any other potential risks associated with the provision of telehealth services, we encourage you to raise such questions or concerns with your Treating Provider  If you elect not to do so, Zest Health, Citrus, and your Treating Provider will assume that you understand the potential risks associated with telehealth services and that you are comfortable proceeding.

Alternatives:

Some people decide that they prefer to see a doctor in person. This is totally fine – it is really important to be comfortable with your health care provider. Let your Treating Provider know if you don’t want telehealth services. You can find a health care provider near you and we can send them your medical records.

Assisting Staff:

As noted above, other people may be present during your visit or near your Treating Provider to operate the telehealth equipment or to provide other assistance. Your Treating Provider wants you to be comfortable sharing information, and it is not a good idea to leave out information because you do not like having another person around. If you would rather be alone with your treating Provider, it is totally okay as long as it will not interfere with your Treating Provider’s ability to provide the telehealth service – just let them know.

Your Medical Records:

The telehealth services that you receive will be recorded in your telehealth medical record that we maintain in our system. You have the right to request a copy of your health records. All you need to do is ask. Your records will be prepared and sent to you as required by law. Sometimes there may be a small charge to cover the cost of preparing and shipping the records. Also, when you sign below, you agree that Citrus and your Treating Provider (and Zest Health on Citrus’ and your Treating Provider’s behalf) may use or send your medical records to others for scheduling and billing purposes. Additional information about your medical records is in our Notice of Privacy Practices.

Complaints:

We also want to know right away if you are having any problems with your Treating Provider. Contact us at support@zesthealth.com or (516) 388-7209 if you have a complaint or want to pick a new Treating Provider. Also, every state has an agency that licenses health care providers. They want to know if a health care provider is not acting properly. You can usually file a complaint with that state agency online. If you need help filing a complaint you can contact us at the above number, or reach out to a local agency for support

Additional State-Specific Information:

Additional State-Specific Consents: The following consents apply to patients accessing Citrus’s website for the purposes of participating in a telehealth consultation as required by the states listed below:

• Iowa: I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website at https://medicalboard.iowa.gov/consumers/filing-complaint.‍
• Idaho: I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website at https://bom.idaho.gov/BOMPortal/AgencyAdditional.aspx?Agency=425&AgencyLinkID=650.
• Indiana: I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website at https://www.in.gov/attorneygeneral/2434.htm.
• Kentucky: I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website at https://kbml.ky.gov/grievances/Pages/default.aspx.
• Maine: I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website at https://www.maine.gov/md/discipline/file-complaint.html.
• Oklahoma: I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website at http://www.okmedicalboard.org/complaint; Or, the Oklahoma Board of Osteopathic Examiners’ website at https://www.ok.gov/osboe/faqs.html.
• Rhode Island: I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website at https://health.ri.gov/licenses/detail.php?id=200.
• Texas: I have been informed of the following notice: NOTICE CONCERNING COMPLAINTS -Complaints about physicians, as well as other licensees and registrants of the Texas Medical Board, including physician assistants, acupuncturists, and surgical assistants may be reported for investigation at the following address: Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Assistance in filing a complaint is available by calling the following telephone number: 1-800-201-9353, For more information, please visit our website at www.tmb.state.tx.us.
• AVISO SOBRE LAS QUEJAS- Las quejas sobre médicos, asi como sobre otros profesionales acreditados e inscritos del Consejo Médico de Tejas, incluyendo asistentes de médicos, practicantes de acupuntura y asistentes de cirugia, se pueden presentar en la siguiente dirección para ser investigadas: Texas Medical Board, Attention: Investigations, 333 Guadalupe, Tower 3, Suite 610, P.O. Box 2018, MC-263, Austin, Texas 78768-2018, Si necesita ayuda para presentar una queja, llame al: 1-800-201-9353, Para obtener más información, visite nuestro sitio web en www.tmb.state.tx.us‍
• Vermont: I have been informed that if I want to register a formal complaint about a provider, I should visit the medical board’s website at http://www.healthvermont.gov/health-professionals-systems/board-medical-practice/file-complaint; Or, the Vermont Board of Osteopathic Examiners’ website at https://www.sec.state.vt.us/professional-regulation/file-a-complaint-employer-mandatory-reporting.aspx.

Emergency:

Telehealth services are NEVER intended to constitute emergency services.  If you believe you are having a medical emergency and/or if you need help right away, please immediately call “911” or present to the nearest emergency room.  Taking care of emergencies must be done in person. Our telehealth system CANNOT contact your local emergency services.

Contact:

If you have any questions, please email us at support@zesthealth.com.