1. Introduction

AvaOne Heart and Wellness (“AvaOne,” “we,” “us,” or “our”), a service of AvaOne LLC, offers certain services through telehealth and virtual visit technology. Telehealth allows you to interact with our team by video, telephone, or other electronic communication technologies without being physically present at one of our office locations.

This Telehealth and Virtual Visit Informed Consent (“Consent”) describes:

    • The types of telehealth services we offer
    • The benefits and risks of telehealth
    • Your rights as a telehealth patient
    • The technology and privacy considerations
    • Situations in which telehealth may not be appropriate

By participating in any telehealth or virtual visit with AvaOne, you acknowledge that you have read, understood, and consent to the terms described in this document.

2. Types of Telehealth Services We Offer

AvaOne uses telehealth and virtual visit technology for the following types of interactions:

2.1 15-Minute Discovery Assessment

Our complimentary 15-Minute Discovery Assessment may be conducted by video call or telephone based on your preference. This is a preliminary conversation to discuss your health goals, review AvaOne’s services, and determine whether AvaOne is a good fit for your needs. The Discovery Assessment does not constitute medical treatment, does not establish a physician-patient relationship, and does not include diagnosis or treatment recommendations for any specific condition.

2.2 Virtual Consultations and Follow-Up Visits

Certain patient interactions after your first in-person visit may be conducted virtually, including:

    • Follow-up visits for Vitality Program members
    • Coaching sessions within the Lifestyle and Wellness Coaching Program
    • Progress check-ins and treatment plan reviews
    • Discussion of lab results or test findings
    • Administrative or care coordination discussions

2.3 Situations Requiring In-Person Care

Certain services require in-person delivery and cannot be conducted virtually, including:

    • The Future Self Assessment (comprehensive 90-minute physician evaluation for Vitality and Coaching patients)
    • The Mapping Assessment (in-person physician evaluation and first StemWave application)
    • Any StemWave Therapy treatment sessions
    • Any physical examination
    • Any procedure requiring physical presence
    • Any emergency evaluation

Your physician will determine whether a specific interaction is appropriate for telehealth or requires an in-person visit.

3. Benefits of Telehealth

Telehealth offers several potential benefits:

    • Convenience and reduced travel time
    • Access to your physician from home or another location of your choice
    • Reduced exposure to illness in a waiting room setting
    • Flexibility in scheduling
    • Improved access to your healthcare team between in-person visits

4. Risks and Limitations of Telehealth

You should understand that telehealth has certain risks and limitations:

4.1 Technical Risks

Telehealth relies on technology that may fail. Risks include:

    • Interruption or disconnection during a visit due to internet, telephone, or hardware issues
    • Poor audio or video quality that limits the effectiveness of the visit
    • Delays in transmission of information
    • Loss of information if a connection is disrupted mid-visit

If a technical failure occurs during your visit, we will attempt to reconnect. If reconnection is not possible, we will contact you by telephone to reschedule or complete the visit through a different method.

4.2 Clinical Limitations

Telehealth is not appropriate for every clinical situation. Limitations include:

    • Inability to perform a full physical examination
    • Inability to perform in-office diagnostic testing during the visit
    • Reduced ability to observe subtle physical findings
    • Reduced ability to build the same rapport as an in-person interaction
    • Certain conditions may require in-person evaluation for accurate diagnosis or treatment

If your physician determines that telehealth is insufficient for your specific situation, they will recommend an in-person visit at one of our office locations.

4.3 Privacy and Security Risks

While we use secure technology and implement safeguards to protect your privacy, telehealth involves the transmission of information over networks that may be subject to interception. Additional privacy risks may arise from:

    • Others in your home or physical location overhearing the conversation
    • Unauthorized recording of the visit by any party
    • Compromise of your device, network, or account credentials
    • Third parties gaining access to your telehealth platform account

You are responsible for ensuring you are in a private location during telehealth visits and that your device and network are secure.

5. Emergency Care and Crisis Situations

5.1 Telehealth Is Not for Emergencies

Telehealth is not appropriate for medical emergencies. If you believe you are experiencing a medical emergency, call 911 or your local emergency number immediately, or go to your nearest emergency room. Do not wait for a telehealth visit.

5.2 Mental Health Crises

If you are experiencing a mental health crisis, thoughts of suicide, or thoughts of harming yourself or others, do not wait for a telehealth visit. Contact:

    • 988 Suicide and Crisis Lifeline (call or text 988)
    • Your nearest emergency room
    • 911

AvaOne is not a mental health crisis service and cannot provide emergency mental health intervention

5.3 If a Crisis Develops During a Telehealth Visit

If a medical or mental health emergency develops during a telehealth visit, your physician will help you access appropriate emergency resources. You may be asked to provide your current physical location so that emergency services can be directed to you if necessary.

6. Confirming Your Location

For every telehealth visit, we will ask you to confirm your physical location at the start of the visit. This is important for several reasons:

    • Physician licensing requirements vary by state; our physicians are licensed to provide care in New Jersey
    • Emergency services must be directed to your actual location if a crisis develops
    • Certain healthcare laws depend on the state in which you are physically located during the visit

You must be physically located in New Jersey at the time of your telehealth visit unless we have confirmed with you in writing in advance that a specific out-of-state visit is permissible. If you are located outside of New Jersey at the time of a scheduled telehealth visit, please notify us immediately so we can determine whether the visit can proceed.

7. Privacy and Confidentiality

7.1 HIPAA Compliance

Telehealth visits are subject to the same privacy protections that apply to in-person visits under the Health Insurance Portability and Accountability Act (HIPAA). Please review our HIPAA Notice of Privacy Practices at avaonewellness.com/hipaa-notice/ for details.

7.2 Telehealth Technology Providers

We use HIPAA-compliant telehealth technology provided by third-party vendors. These vendors are bound by Business Associate Agreements (BAAs) that require them to protect your information consistent with HIPAA requirements.

7.3 Recording

Telehealth visits will not be recorded by AvaOne without your written authorization, except as may be required by law. You agree that you will not record any telehealth visit without our written consent.

7.4 Documentation in Your Medical Record

Telehealth visits are documented in your medical record in the same manner as in-person visits. The documentation becomes part of your protected health information and is subject to the same protections as any other portion of your medical record.

8. Technology Requirements

To participate in a telehealth visit, you will need:

    • A device with a working camera and microphone (smartphone, tablet, or computer) for video visits
    • A working telephone for telephone visits
    • A reliable internet connection (for video visits)
    • A private space where the visit will not be overheard
    • Any specific application or platform we ask you to use in advance of the visit

Instructions for accessing your specific telehealth visit will be provided in advance. If you have questions about the technology, please contact our office at (973) 679-6949.

9. Payment for Telehealth Services

9.1 Self-Pay Practice

AvaOne is a self-pay practice. Telehealth services are subject to the same payment terms as in-person services. We do not bill insurance for telehealth visits and do not submit claims to any insurance company or government program.

9.2 The 15-Minute Discovery Assessment Is Complimentary

The 15-Minute Discovery Assessment, whether delivered by video or telephone, is complimentary (a $79 value). No payment is required for the Discovery Assessment.

9.3 Other Telehealth Visits

Other telehealth visits (follow-up visits, coaching sessions, etc.) are billed at the same rates as their in-person equivalents. Pricing is confirmed in advance of your visit.

10. Medicare and Medicaid Patients

AvaOne cannot provide telehealth services (including the 15-Minute Discovery Assessment) to patients who are enrolled in or eligible for Medicare or Medicaid. This limitation applies to all telehealth interactions, including preliminary Discovery Assessment calls. Please review our Self-Pay Practice Notice at avaonewellness.com/self-pay-practice-notice/ for full details on our Medicare and Medicaid policy.

If you are enrolled in or eligible for Medicare or Medicaid, please obtain care from a provider that participates in your program.

11. Your Rights as a Telehealth Patient

You have the following rights with respect to telehealth services at AvaOne:

    • Right to refuse telehealth. You may decline a telehealth visit at any time and request an in-person visit instead, subject to availability and clinical appropriateness
    • Right to switch to in-person. During a telehealth visit, if you decide you would prefer to continue in person, you may request rescheduling to an in-person visit
    • Right to end the visit. You may end a telehealth visit at any time
    • Right to a qualified provider. All telehealth visits are conducted by AvaOne physicians who are licensed in the state where you are physically located
    • Right to privacy. Your telehealth visit is protected by the same privacy protections as an in-person visit
    • Right to your records. Telehealth visits are documented in your medical record; you have the same rights to access and review your records as with any other visit
    • Right to withdraw consent. You may withdraw this consent at any time by notifying our office in writing; withdrawal will not affect any care already provided

13. Changes to This Consent

We reserve the right to update this Telehealth and Virtual Visit Consent from time to time. When we make material changes, we will update the “Last revised” date at the top of the document and notify affected patients as appropriate. The revised Consent will apply to telehealth visits occurring after the effective date of the revision.

14. Contact Information

If you have questions about this Consent, telehealth services, or your telehealth visit, please contact:

AvaOne Heart and Wellness
 2 Lincoln Hwy, Suite 311B
 Edison, NJ 08820

Phone: (973) 679-6949
 Email: info@avaonewellness.com

15. Related Notices

This HIPAA Notice of Privacy Practices is one of several notices that govern your relationship with AvaOne Heart and Wellness. Please also review: