Alori Health Medical, Telehealth, HIPAA, Financial, and Shipping Consent

Effective Date: April, 23 2026

IMPORTANT: Alori Health is not a substitute for emergency medical care. If you believe you are experiencing a medical emergency, call 911 or seek in-person emergency medical care immediately.

We may update these consent terms from time to time as required by law or as needed for operational, legal, or business reasons. Updated terms will apply as permitted by law.

I. Telehealth Consent

Telehealth is a form of care that allows patients to access healthcare services remotely using technology, which may include audio, video, electronic communications, digital forms, secure messaging, or other approved telehealth tools.

Electronic systems used in connection with telehealth are designed to incorporate security protocols intended to protect the confidentiality of your identity, health information, and related data, and to help safeguard against unauthorized access, corruption, or unintended disclosure.

Expected Benefits of Telehealth

Potential benefits of telehealth may include:

• improved access to care across distance or location barriers;

• more convenient access to evaluation, follow-up, and treatment support;

• greater efficiency in receiving certain health and wellness services;

• access to expertise from providers who may not be physically located near you; and

• continuity of care when remote access is appropriate.

Possible Risks of Telehealth

As with any healthcare service, there are potential risks associated with telehealth. These risks may include, but are not limited to:

• in rare cases, transmitted information may be inadequate for appropriate clinical decision-making, such as poor image quality, incomplete intake information, or technical limitations;

• delays in care due to equipment failure, connectivity issues, platform outages, or other technology-related problems;

• in rare situations, security protections may fail, which could result in a privacy or confidentiality breach;

• lack of access to complete records, medication history, allergies, or other clinical information that could affect care decisions; and

• the possibility that telehealth may not be appropriate for certain conditions, concerns, or clinical situations.

By consenting to telehealth, you acknowledge and understand the following:

• The laws protecting the privacy and confidentiality of medical information also apply to telehealth.

• Information obtained during telehealth that identifies you will not be disclosed to researchers or other non-authorized parties without your consent, except as permitted or required by law.

• You have the right to withhold or withdraw your consent to telehealth at any time, without affecting your right to future care or treatment where otherwise available.

• You have the right to inspect information obtained and documented during telehealth interactions and to request copies, subject to applicable law and reasonable fees where permitted.

• Alternative methods of care may be available to you, and you may choose alternative options where available.

• It is in your best interest to inform your provider or clinical staff of any other healthcare providers involved in your care.

• No outcome, diagnosis, treatment result, prescription, or improvement can be guaranteed through telehealth services.

Client Consent to the Use of Telehealth

By continuing to use the services, you confirm that you have read and understood the information above regarding telehealth, that you have had the opportunity to ask questions and have those questions answered to your satisfaction, and that you voluntarily give your informed consent to the use of telehealth in connection with your care through Alori Health and independent licensed providers.

You acknowledge that your continued use of the services constitutes your acceptance of and consent to telehealth in the course of your evaluation, diagnosis, treatment, and related care coordination, where appropriate.

II. HIPAA Consent and Privacy Acknowledgment

The Health Insurance Portability and Accountability Act (HIPAA) provides protections for the privacy and security of your protected health information (PHI).

This section is intended as a general acknowledgment of how your information may be handled in connection with services available through Alori Health. A more complete description of privacy practices is available in our Notice of Privacy Practices.

What this means

There are rules and restrictions regarding who may access, use, or receive your PHI. These restrictions do not prevent the normal sharing of information necessary to provide healthcare services, coordinate care, process payments, support operations, or comply with legal obligations.

We have adopted the following general privacy practices:

• Your information will be kept confidential except as necessary to provide services, coordinate care, process payments, support healthcare operations, or comply with legal obligations.

• Your information may be shared with independent licensed providers, pharmacies, laboratories, payment processors, insurers or payers where applicable, service vendors, and other authorized parties as necessary to support your care and related administrative functions.

• Vendors and service providers that assist in operating the business may have access to PHI, but they are required to protect confidentiality as required by law.

• We may contact you regarding appointments, follow-up items, account matters, prescription coordination, policy updates, billing matters, or other service-related issues by telephone, email, text message, portal message, U.S. mail, or other reasonable means.

• Government agencies, accreditation bodies, insurers, or other authorized entities may review records or documentation containing PHI when permitted or required in the normal course of oversight, compliance, or payment review activities.

• You may raise privacy concerns or complaints with us at any time.

• Your PHI will not be used for marketing purposes where prohibited by law without any required authorization.

• We will provide access to your records in accordance with applicable federal and state law.

• We may update internal privacy practices and procedures as permitted by law.

• You may request restrictions on certain uses or disclosures of your PHI, but we are not always required to agree except where the law requires us to do so.

By continuing to use the services, you acknowledge that you have read and understood this HIPAA-related information, that you understand a more complete Notice of Privacy Practices is available, and that your consent remains in effect unless revoked where permitted by law.

III. Financial Consent

By using the services, you understand and agree to the following financial terms:

• A valid payment method, including a credit or debit card, may be kept on file where permitted and necessary to process charges related to services, consultations, subscriptions, medications, shipping, or other authorized charges.

• You are responsible for payment of all balances due for services rendered, products ordered, subscription charges, shipping charges, or related fees not otherwise covered by credits, vouchers, or other approved adjustments.

• You authorize Alori Health to use your payment information to process charges you approve or incur through your use of the services.

• You authorize the release of information reasonably necessary to process your consultation request, order, billing transaction, or care-related service.

• Fee schedules, order summaries, and receipts may be made available upon request or through your account, where applicable.

• You authorize Alori Health to correct invoice errors and charge your payment method for orders placed, goods received, services rendered, or unpaid balances due.

• You authorize Alori Health to charge your card for unpaid balances owed in connection with your use of the services.

Auto-Renewal Acknowledgment

If you enroll in a recurring plan, membership, subscription, or auto-renewing program, you understand and agree that the program may renew automatically unless you cancel in accordance with the applicable cancellation policy before your next billing date.

By continuing with enrollment or use of such a program, you consent to automatic recurring charges for the program unless and until you properly cancel.

Refunds and Payment Disputes

Refund eligibility, if any, is governed by the applicable cancellation and refund policy. Except where otherwise stated in that policy or required by law, fees for services already rendered and medication-related charges may not be refundable.

You certify that you are an authorized user of the payment method provided.

IV. Shipping Authorization

Prescription medications, where prescribed, are dispensed and shipped in accordance with applicable state and federal law, subject to the approval and professional oversight of the dispensing pharmacy and pharmacist, and in compliance with applicable medical and pharmacy board requirements.

By authorizing shipment, you understand and agree that:

• medication orders may be fulfilled and shipped by a third-party licensed pharmacy;

• shipping timelines may vary;

• delays, carrier issues, weather events, address problems, or fulfillment disruptions may occur;

• Alori Health does not guarantee carrier performance or shipping timelines; and

• medication may be considered dispensed and the order completed when released for shipment by the pharmacy, even if final delivery occurs later.

You agree to hold harmless Alori Health, to the fullest extent permitted by law, for shipping delays or carrier-related delivery issues outside of its direct control.

By continuing to use the services, you authorize medication, where prescribed and lawfully dispensed, to be shipped to the address provided in your intake materials or to another address you provide and confirm as authorized for delivery, subject to pharmacy approval and applicable law.

V. General Acknowledgment

By continuing to use the services, you acknowledge that:

• you have read and understand this Medical, Telehealth, HIPAA, Financial, and Shipping Consent;

• you have had the opportunity to ask questions;

• you agree to these terms voluntarily;

• your electronic acceptance and continued use of the services constitutes your consent to these terms; and

• these consents remain in effect unless withdrawn or modified where permitted by law.

VI. Contact Information

If you have questions about these consent terms, please contact:

Alori Health
Email: support@alorihealth.com
Phone: (786) 618-2694
Address: 66 W Flagler Street, Suite 900, PMB 12277, Miami, FL 33130

Important Platform Disclosure

Alori Health is a platform that works with independent licensed providers and third-party healthcare partners. Alori Health does not directly provide medical care or pharmacy services. Medical care is provided by independent licensed providers, and prescription fulfillment is handled by licensed pharmacies where appropriate and permitted by law.