Legal

Telehealth Informed Consent

Last reviewed August 14, 2026

Effective August 14, 2026

Welcome to Bloom360! We're so glad you're here. Before we start taking care of you, we want you to know exactly what care with us looks like: what we can do well over video and messaging, what we honestly can't, and what your rights are the whole way through. Please read this. It isn't long, and it's written to be understood. If anything is unclear, ask us at care@bloom360.com before you agree.

This Telehealth Informed Consent (“Consent”) provides you with important information about telehealth services and obtains your informed consent to receive healthcare from Bloom360 Medical PLLC and its affiliated professional entities (the “Practice”) using the telehealth platform operated by Bloom360, Inc. (“Bloom360”). The Practice employs or contracts with licensed healthcare professionals (“Providers”) who deliver your medical care. Bloom360, Inc. provides the technology platform, administrative services, and operational support but does not practice medicine or provide clinical care.

By clicking “I Agree,” checking a related box, or using any other acceptance protocol presented during account creation or before your first visit, you acknowledge that you have read and understood this Consent, that you voluntarily agree to receive telehealth services as described herein, and that your electronic acceptance is equivalent to your handwritten signature.

You are not required to consent to telehealth as a condition of receiving any other services. You may obtain healthcare from another provider, including through in-person visits, at any time. Your decision to use or not use telehealth will not affect your right to future care.

Telehealth is the delivery of healthcare services using electronic communications, information technology, and telecommunications technology when you and your provider are not in the same physical location. Bloom360 is a primary care telehealth clinic built on ongoing, relationship-based care delivered entirely through telehealth, including synchronous video visits and asynchronous messaging with your care team.

Telehealth may involve the use of secure video conferencing, secure messaging, electronic health records, and other digital health tools to deliver care, communicate health information, and coordinate services. Telehealth may be used for diagnosis, treatment, follow-up, patient education, care coordination, and prescription management.

When you join Bloom360, you are assigned a dedicated care team that may include:

  • Primary Care Provider (PCP): A licensed physician or advanced practice provider who oversees your preventive care, manages acute and chronic conditions, orders tests and prescriptions, and coordinates your overall health plan.
  • Wellness Coach: A team member who provides general wellness education, health coaching, and relays physician-approved recommendations to support your overall well-being. Wellness coaches operate under the direction of your primary care provider. Wellness coaches do not diagnose medical conditions, prescribe medications, or independently make clinical decisions. Wellness coaching is not medical care and is not a substitute for it. When a question needs a clinician, your coach will bring one in.

All Providers delivering clinical services through Bloom360 are licensed in the state where you are physically located at the time of your telehealth encounter. Other members of the care team, including non-clinical personnel, may participate in or observe your visit to aid in the delivery of your care, with notice as required by applicable law.

Before or at the start of your first visit, we will tell you your Provider's full name and professional credentials. You can ask for that information again at any time, and you can ask which state your Provider is located in.

If a visit is interrupted by a technology failure, your Provider will attempt to reach you by telephone at the number on your account. If you do not hear from us within a few minutes, call (833) 348-3044. If the problem cannot be resolved, we will reschedule at no additional cost to you.

Telehealth services may offer the following benefits:

  • Improved Access: Ability to receive care from your home or any private location without travel.
  • Scheduling Flexibility: More convenient appointment times that fit your schedule.
  • Reduced Costs: Elimination of travel time and associated expenses, with transparent membership pricing.
  • Continuity of Care: Ongoing relationship with a dedicated care team that knows your history.
  • Ongoing Support: Access to asynchronous messaging with your care team between scheduled visits for questions, follow-ups, and health coaching.

We'd rather over-explain this part than have you find out mid-visit. As with any healthcare service, telehealth has potential risks and limitations that you should understand before consenting:

Clinical Limitations

  • Your Provider cannot perform a hands-on physical examination, which may limit diagnostic capabilities.
  • Certain conditions may require in-person evaluation, diagnostic testing, or specialist referral that cannot be provided through telehealth.
  • Delays in evaluation or treatment may occur if your Provider determines that telehealth is not appropriate for your situation.
  • Your Provider may not have access to your complete medical history from other providers, which could affect care decisions.
  • The information available to your Provider during a telehealth encounter may be limited compared to an in-person visit, which could affect diagnostic accuracy.

Technology Risks

  • Poor internet connectivity, hardware malfunctions, or software issues may interrupt or degrade the quality of your visit.
  • Audio or video quality may be insufficient for clinical assessment in some cases.
  • Technical difficulties may cause delays or require rescheduling your appointment.

Security Risks

  • Despite our security measures, electronic communication carries inherent risks, including the possibility of unauthorized interception of your health information.
  • We use encryption and other safeguards to minimize these risks, but no system can guarantee absolute security.

Bloom360 provides virtual primary care services. Our scope of care includes:

  • Wellness visits and annual health assessments
  • Chronic disease management (e.g., hypertension, obesity, high cholesterol))
  • Health coaching and lifestyle modification support
  • Medication management
  • Lab and diagnostic test ordering
  • Referrals and care coordination
  • Wellness coaching

Prescriptions: Your Provider may prescribe medications, including controlled substances in limited circumstances, when clinically appropriate and permitted by applicable federal and state law. Federal rules allowing controlled substances to be prescribed by telemedicine without a prior in-person examination are currently in effect on a temporary basis and are scheduled to expire on December 31, 2026. If those rules change, our prescribing practices will change with them. All prescribing decisions are made by licensed Providers exercising independent clinical judgment. Not all medications can be prescribed via telehealth, and a prescription is never guaranteed. Prescription medications are not included in your membership fee and are obtained through a pharmacy of your choice at your own expense.

Bloom360 does NOT provide:

  • Emergency medical services
  • Specialist care (e.g., cardiology, oncology, surgery)
  • Mental health crisis intervention
  • In-person care

If your Provider determines that your condition requires in-person evaluation, emergency care, or specialist referral, they will advise you accordingly.

By accepting this Consent, you consent to receive medical evaluation, diagnosis, treatment, and care from the Practice and its Providers through telehealth, including the ordering of laboratory and diagnostic tests, the prescribing of medications where clinically appropriate, and referrals to other clinicians or facilities.

You consent to the collection of laboratory specimens at a patient service center or by an at-home collection kit, and to the laboratory releasing those results to your care team. Laboratory and diagnostic testing may involve additional cost that is not included in your membership fee, and we will tell you before ordering anything that we expect to carry a separate charge.

No one can promise you a particular medical outcome, and nobody here will. Your Providers will use reasonable skill and judgment, and they will tell you plainly when telehealth is not the right setting for what you need.

You may refuse or withdraw consent to any specific test, treatment, or medication at any time, and your Provider will discuss the alternatives and the risks of declining with you.

The Practice and Bloom360 may use artificial intelligence and automated tools in connection with your care, including for clinical documentation, care plan recommendations, health risk assessments, and patient-facing features such as automated care assistants, chat-based tools, and interactive health assessments. These tools operate under the oversight of your care team and do not independently make medical decisions or diagnoses. All clinical decisions are made by licensed Providers. You may request to speak with a member of your care team at any time. You may also ask us not to use an AI scribe or assistant during a specific visit, and we will honor that request. Declining never affects your care. Where a message to you was drafted with the help of generative AI, we will say so and tell you how to reach a person.

For quality assurance, training, and compliance purposes, your telehealth visits and communications with your care team, including video sessions, telephone calls, and in-app messaging, may be recorded or monitored. We will obtain your consent to recording as required by applicable law. You may request that a specific interaction not be recorded at the beginning of that interaction.

The Practice and Bloom360 are committed to protecting your health information. Our telehealth platform complies with the Health Insurance Portability and Accountability Act (HIPAA) and applicable state privacy laws. Safeguards include:

  • Encryption of all data in transit and at rest
  • Role-based access controls limiting information access to authorized care team members
  • Business Associate Agreements with third-party vendors where required by law, and written commitments from our other vendors to protect your information
  • Regular security assessments and audits

For more information, please review our Privacy Policy and Notice of Privacy Practices at bloom360.com/privacy.

Bloom360, Inc. and the Practice have a financial relationship. Bloom360, Inc. provides administrative, technology, and operational support to the Practice under a management services arrangement. This financial relationship does not influence the clinical decisions made by your Providers, who exercise independent medical judgment at all times.

By accepting this Consent, you certify that you are physically located in the state you have identified as your current location. Your ability to receive telehealth services through Bloom360 is conditioned upon the truthfulness of this certification. Providers are relying on your location certification to ensure they are licensed to practice in the state where you are located. If your location certification is inaccurate, you agree to hold the Practice and its Providers harmless from any resulting claims, costs, or damages.

You have the right to access your health records maintained by the Practice. You may view your records through your Bloom360 account or request copies by contacting us at care@bloom360.com or (833) 348-3044. We will provide your records in a timely manner in accordance with applicable law.

As a Bloom360 patient, you have the right to:

  • Receive information about your diagnosis, treatment options, and prognosis in terms you can understand
  • Participate in decisions about your care, including the right to refuse or withdraw consent for treatment at any time
  • Request a second opinion or referral to another provider
  • Access your health records and request amendments to inaccurate information
  • Privacy and confidentiality of your health information
  • Be treated with dignity, respect, and without discrimination
  • File a complaint or grievance without fear of retaliation
  • Receive a clear explanation of fees and charges
  • Obtain care from another provider at any time, including in-person care

As a Bloom360 member, you agree to:

  • Provide accurate and complete health information to your care team, including your current medications, allergies, health history, and any changes in your condition
  • Follow the treatment plan agreed upon with your care team, or communicate with your team if you are unable to do so
  • Ensure you are in a private, secure, and appropriate location during telehealth visits
  • Use a device with a functioning camera, microphone, and stable internet connection for video visits
  • Notify your care team promptly of any adverse reactions, unexpected symptoms, or changes in your health status
  • Treat all Bloom360 staff and Providers with respect and courtesy
  • Keep your account and contact information up to date
  • Not record telehealth visits without the prior consent of all participants
  • Accurately report your physical location at the time of each telehealth encounter

If you are accepting this Consent for another person, you represent that you are that person's parent, legal guardian, or authorized healthcare decision maker, and that you have the legal authority to consent to their care. We may ask you for documentation of that authority.

Patients under the age of eighteen may receive care only with the consent of a parent or legal guardian, except where state law allows a minor to consent to particular care on their own. Where state law gives a minor the right to consent to and control the confidentiality of certain care, we will follow that law, which may mean we cannot share some information with a parent or guardian.

If someone else joins your visit, whether a family member, a caregiver, or an interpreter, we will ask for your agreement first, and they will be introduced to you.

Bloom360 does not provide emergency medical services. If you are experiencing a medical emergency:

  • Call 911 or go to the nearest emergency room immediately for life-threatening situations.
  • Call 988 (Suicide and Crisis Lifeline) if you are experiencing a mental health crisis, suicidal thoughts, or emotional distress.
  • Contact your local urgent care center for non-life-threatening conditions that require immediate attention.

Do not rely on Bloom360 for urgent or emergency care. Our Services are designed for scheduled and asynchronous preventive care, not real-time emergency response. Messages you send us are not monitored in real time. We aim to respond to non-urgent messages within one business day, and we will tell you in the app if that changes. A message is never the right tool for an emergency. If at any time your Provider determines that your condition requires emergency care, they will advise you accordingly.

Telehealth services are subject to the laws and regulations of the state where you are physically located at the time of your encounter. Depending on your state, additional consent requirements, disclosures, or limitations may apply. Any additional state-specific terms that apply to you are set out in the state addendum to this Consent, which is presented to you at signup and forms part of this Consent.

You have the right to withdraw your consent for telehealth services at any time by notifying us at care@bloom360.com or by calling (833) 348-3044. Withdrawal of consent will not affect any services provided prior to the withdrawal or any action taken by the Practice in reliance on this Consent before receiving your notice.

If you withdraw consent, you may not be able to continue receiving services through Bloom360, as our care model is delivered exclusively via telehealth. Withdrawal of consent does not affect your right to obtain care from another provider.

We may update this Consent from time to time. When we make material changes, we will provide notice through our platform or by email. The updated Consent will indicate the date of the most recent revision. Your continued use of our Services after the effective date of any changes constitutes your acceptance of the updated Consent.

Questions about any of this? Ask before you agree, not after. A real person reads every message that comes in:

  • Email: care@bloom360.com
  • Phone: (833) 348-3044
  • Mail: Bloom360, Inc., Attn: Patient Services, 4444 2nd Ave Ste 30674, Detroit, MI 48201

By checking the boxes presented with this Consent and/or clicking “I Agree,” you confirm that you have read and understood this Consent, that you have had the chance to ask questions, and that you voluntarily agree to receive care from the Practice through telehealth. Your electronic acceptance has the same effect as a handwritten signature. We record the version of this Consent you accepted, together with the date and time of your acceptance, and we will give you a copy of it any time you ask.