Vita Health Services Agreement
The Vita Health Services Agreement is a legal agreement between Vita Health Services, PLLC / Vytyl Health Management, Inc ("Vita Health Services," "we" or "us") and the person ("you", "your", or "user") who accesses or uses the Services. This Agreement describes the terms and conditions that apply to your use of the Services. If you do not understand any of the terms of this Agreement, please contact us at email@example.com before using the Services. You may not access or use any Services unless you agree to abide by all of the terms covered by this Agreement. The Agreement consists of the following terms:
A summary of the Agreement is as follows:
- Services provided consist of behavioral health interventions including telehealth (the practice of delivering clinical health care services via technology between a provider and a patient who are not in the same physical location), group therapy, parent and family support and/or digital tools.
You consent to receive Vita Health telehealth services, if deemed appropriate. Telehealth involves:
- the secure communication of patient health information (PHI) to Vita Health
- benefits and limitations
- risks related to diagnosis, technology issues, and confidentiality
- possible recording of video, audio and/or digital photographs for training and quality improvement purposes, and,
- confidentiality of your medical information
- There are potential side effects of mental health treatment and suicidality treatment.
- You are under no obligation to use Vita Health services and may withdraw at any time without affecting future services.
- You will provide your physical residence location information to Vita Health, and will be matched with a provider who is licensed where you are located, when required.
- Vita Health has permission to use contact information that you provide to call, text and email you.
You will provide Vita Health with current, complete, true and accurate information, including timely updates to changes in your medical or mental health.
- Vita Health team will have access to your personal health information (PHI) and will access it to deliver, coordinate and advance your plan of care (in accordance with the Terms of Service and Private Policy)
- Except as required by law or regualtion, Vita health will not be liable for any personal injury, medical malpractice, suicide, suicide attempts, wrongful death and/or survivorship actions.
- Duration of services varies based on condition and individual situations; and there is no guarantee that your condition will improve while receiving services.
- You will pay for the cost of services either directly or through health insurance. You are responsible for all co-pays, non-covered portions or deductibles; and you will pay a fee ($50 individual therapy; $25 group) if you miss an appointment without notice or cancel an appointment within 24 hours. Multiple missed sessions or late cancellations will result in discharge from the program.
- You are committing to engage in Vita Health services.
- You may live in a state where parental consent is required for minors to participate in services. You understand that if you are using health insurance, information regarding services will be shared with the health plan and the policyholder.