This consent document serves to provide information and obtain consent for services offered by LainaHealth, including Virtual Physical Therapy (VPT) services and the Wellness Program. Clients seeking either or both services must read and acknowledge their understanding of the terms herein. Consent may be withdrawn at any time by providing written notice to LainaHealth and/or its affiliates.

Client acknowledges that:

• Physical therapy and Wellness Programs are not a substitute for a medical diagnosis by a physician;
• Physical therapy and Wellness Programs are not based on radiological imaging;
• A physical therapist cannot diagnose an illness or disease; and
• The patient's health insurance may not include coverage for the physical therapist's services.

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Service-Specific Information

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Virtual Physical Therapy (VPT) Services

The purpose of physical therapy is to treat disease, injury, and disability through examination, evaluation, and intervention using rehabilitative procedures, manual techniques, exercises, and physical agents. Due to the nature of telehealth services, some services may be limited. These services are provided by licensed physical therapists, and clients must provide accurate and complete medical information.

Potential risks include:

• Technical issues such as unclear video, audio loss, or connection interruptions.
• Limited ability to conduct hands-on examination and treatment.
• Potential breaches of personal medical information despite robust security measures.

By consenting, you acknowledge and accept these risks and agree to communicate any concerns or technical difficulties.

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Wellness Program Services

The Wellness Program offers services designed to promote general health and wellness. Practitioners may be licensed physicians or physical therapists, however services provided will not be within the scope of that license nor do those services substitute for medical or physical therapy care. Clients must provide accurate information relevant to the services received.

Potential risks include:

• Technical issues such as unclear video, audio loss, or connection interruptions.
• Limited ability for hands-on assistance.
• Potential breaches of personal information despite robust security measures.

These services are non-diagnostic and non-therapeutic. By consenting, you acknowledge and accept these limitations.

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Transitions Between Services

Clients may have the opportunity to transition between the following services based on their needs, progress, or goals:‍

1. From a Virtual Physical Therapy (VPT) program to an unmonitored Digital Exercise Program.

• Transitioning to an unmonitored Digital Exercise Program involves the use of pre-recorded or automated exercise protocols without real-time supervision by a physical therapist.
• By consenting to this transition, you acknowledge and understand that the unmonitored nature of the program limits the ability to provide immediate feedback or interventions.

2. From a Virtual Wellness Program to a Virtual Physical Therapy Program.

• Transitioning to a Virtual Physical Therapy Program requires an evaluation by a licensed physical therapist to determine your eligibility and appropriateness for treatment.
• By consenting to this transition, you acknowledge that the goals, risks, and benefits of physical therapy services may differ from those of the Wellness Program.

Important Considerations

• Each transition will be discussed with you, including the purpose, limitations, and potential risks.
• You will have the opportunity to ask questions and provide explicit consent for any transition.
• A new consent acknowledgment may be required depending on the nature of the transition.

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Digital Wellness/Physical Therapy

Digital wellness and physical therapy involve the use of audio, video, or other electronic communication to interact with a practitioner or healthcare provider. The session may include consultations, assessments, or treatments facilitated remotely using technology. Services provided via these modalities are subject to the following:

• Technology Requirements: You must have access to appropriate devices and internet connectivity to participate.
• Limitations: Direct, face-to-face communication is not involved, and hands-on assistance is unavailable.
• Privacy Risks: Risks include breaches of confidentiality, theft of personal information, or interruptions due to technical difficulties.
• Emergency Protocols: In emergencies, alternate communication methods may be used.
• Remote Therapeutic Monitoring: Services may include remote therapeutic monitoring to track progress and enhance treatment plans. This monitoring is conducted via secure platforms and is compliant with applicable privacy regulations.

By consenting, you acknowledge your understanding of these terms and agree to participate in services delivered through digital means.

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Risks, Benefits, and Alternatives

By agreeing to these terms, you acknowledge that you understand that there are risks and benefits to Virtual Physical Therapy and Wellness Program services. Both Virtual Physical Therapy and Wellness Program services offer the convenience of remote access to services from home or other locations. Potential risks of the LainaHealth's virtual services include:

• A lack of hands-on assistance,
• potential technical difficulties,
• rare risks of transmitting information over the internet apply, or
• limited ability to respond to emergencies.

Your LainaHealth practitioner, may discontinue or reschedule an appointment if the video quality or audio connection is not adequate for the situation. You agree to not hold LainaHealth responsible for lost information due to technological failures.

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Finalization of Billing

Once an evaluation or consultation is completed, billing for services will be finalized. Exceptions will only be made if the session is deemed incomplete for viable cause, as determined by LainaHealth.

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Email and SMS Communication Consent

Confidential and secure communication with LainaHealth practitioners can take place through the Secure Messaging feature in the Client Portal. However, for basic communication purposes, such as scheduling appointments, clients may choose to use email or SMS.

By consenting, you acknowledge the following:

• Email and SMS communications are not fully secure, and their privacy cannot be guaranteed.
• Laina
• Health does not offer medical advice, physical therapy, or emergency care via email or SMS.
• It is your responsibility to ensure that your contact information is current and accurate.

You may opt out of email and SMS communication at any time by notifying LainaHealth and/or its affiliates in writing.

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Consent for Video Recording

LainaHealth requests your permission to record individual and group sessions via HIPAA-compliant video recordings. These recordings allow us to provide an additional level of supervision and quality assurance.

By consenting, you acknowledge the following:

• No recording will occur without your prior knowledge and consent.
• Recordings may be viewed by supervisors, staff, or professional colleagues within LainaHealth and will not be shared with any external third parties unless required by law.
• All recordings are protected by encryption, access controls, and HIPAA-compliant storage systems.

You may revoke your consent for video recording at any time.

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Records

LainaHealth will maintain records of the services provided to you, including but not limited to notes, assessments, and relevant communications. These records are stored securely and are compliant with applicable laws, including HIPAA.

You are entitled to request copies of your records or summaries. LainaHealth may charge an appropriate fee for preparing or providing these records. If you wish to access your records, LainaHealth recommends doing so with a provider present to discuss the content, as professional records may be misinterpreted by untrained readers.

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Confidentiality

All session content and materials will be held confidential unless disclosure is required by law or explicitly authorized by the client in writing. LainaHealth maintains HIPAA-compliant records and ensures the security of communications and recordings.

Privacy Policy:
https://www.lainahealth.com/privacy-policy

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Consent and Acknowledgment

By agreeing to the terms of this document, you acknowledge your understanding of the services, their limitations, and the associated risks. You also consent to the use of telehealth or digital wellness services as applicable.

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Treatment of Minors

For clients who are minors (under the age of 18), the following additional terms and conditions apply:

1. Parental/Guardian Consent:

• A parent or legal guardian must provide consent for any minor receiving services from LainaHealth, including Virtual Physical Therapy (VPT) services, the Wellness Program, or any associated services.
• By providing consent, the parent or guardian agrees to supervise and ensure the minor’s participation in the recommended services.

2. Parent/Guardian Responsibilities:

• The parent or guardian is responsible for ensuring the minor has appropriate access to the required technology (e.g., devices, internet connection) for virtual or digital services.
• The parent or guardian must provide accurate and complete information about the minor’s health history, medical conditions, or other relevant details to ensure proper care.

3. Privacy and Confidentiality:

• LainaHealth will maintain confidentiality of the minor’s medical records and session details as required by law. However, parents or legal guardians may have access to the minor’s records unless restricted by applicable laws or legal orders.

4. Supervision of Services:

• For certain services, including unmonitored Digital Exercise Programs or other digital wellness offerings, a parent or guardian may be required to monitor the minor’s participation to ensure safety and adherence to the recommended protocols.

5. Transition of Care for Minors:

• If a minor transitions between services (e.g., from Virtual Physical Therapy to a Digital Exercise Program), the parent or guardian must provide consent for the transition. A licensed provider will determine the appropriateness of such transitions, and any new terms or risks will be discussed prior to implementation.

6. Legal Age of Consent:

• Upon reaching the age of majority (18 years old), the minor will be required to provide their own consent for continued services. At that time, the parent or guardian’s consent will no longer be valid unless otherwise required by law.

By signing this document, the parent or legal guardian acknowledges their understanding and agreement to these additional terms and conditions for the treatment of a minor.