Telehealth Consent

About Our Telehealth Care

Ascenva Labs partners with OpenLoop Health to deliver licensed clinical care to patients across all 50 states and Washington D.C. OpenLoop Health, Inc. and its affiliated professional corporations (the "Practice") employ or contract with the licensed clinicians who evaluate, consult with, and prescribe for Ascenva Labs patients. When you sign up for care through Ascenva Labs, you are receiving telehealth services from the Practice through Ascenva's platform.

Who Provides Your Care

Telehealth services are provided by the following affiliated medical practices, depending on the state in which you are physically located:

• OpenLoop Healthcare Partners, PC
• OpenLoop Healthcare Partners California, PC
• OpenLoop Healthcare Partners Colorado, PC
• OpenLoop Healthcare Partners New Jersey Professional Corporation
• OpenLoop Healthcare Partners Wisconsin, S.C.
• OpenLoop Healthcare Partners Puerto Rico, P.C.
• Reliant MD Medical Associates PLLC
• Untitled Health PLLC

For the full and current list of participating clinical entities, the credentials of your treating clinician, and detailed information about how telehealth visits are conducted, please refer to the OpenLoop Telehealth Consent linked above.

What Telehealth Consent Covers

The OpenLoop Telehealth Consent explains:

• What telehealth is and how it differs from in-person care
• The risks, benefits, and alternatives of telehealth
• How your information is communicated and protected during a telehealth visit
• Your right to withdraw consent at any time without affecting future care
• How to obtain follow-up care, emergency care, or in-person care if needed
• The professional credentials and licensure of the clinicians providing your care
• State-specific telehealth requirements where applicable

Required Before Care Begins

You must read and consent to the OpenLoop Telehealth Consent before any consultation, evaluation, or prescription can occur. This consent is collected during the intake process and is also available for review at any time at the link above. By proceeding with care through Ascenva Labs, you acknowledge that you have reviewed, understood, and agreed to the OpenLoop Telehealth Consent.

State Coverage

Some states require synchronous (live video or phone) consultation before certain medications may be prescribed, and some states restrict the prescription of certain controlled or compounded medications via telemedicine. You will be informed during intake if a service you have requested is not available in your state. All telehealth services are limited to patients physically located in the United States at the time of care.

Patient Support

If you need to contact the Practice directly regarding clinical matters, your treating clinician, or your telehealth consent:

OpenLoop Patient Support
Phone: (855) 597-1248
Address: Openloop Tower, 317 6th Ave, Des Moines, IA 50309
Web: openloophealth.com/patient-support

For Ascenva Labs platform support (account, billing, technical issues):

Ascenva Labs Support
Email: hello@ascenvalabs.com
Phone: (772) 918-9876