Virtual Medical Consent 

Medical (Non-Aesthetic) Consultation

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Thank you for your interest in The Pout Medical Aesthetics.
Please review the following information carefully before proceeding.

 

Scope of This Consultation

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This consent applies exclusively to a medical (non-aesthetic) consultation conducted via telemedicine with our Nurse Practitioner Carol Deutsch.

• All new patients are required to complete a medical consultation with our Nurse Practitioner prior to receiving any prescription-based medical services.

• A medical consultation is distinct from an aesthetic consultation.

  • Medical consultations are conducted by Nurse Practitioner Carol Deutsch.

  • Aesthetic consultations are optional and are provided separately by Jennifer Wittkopp, Aesthetic Injector.

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Returning Patients

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Returning patients must ensure their medical consent and consultation are current within the past 12 months, or sooner if there has been a change in medical history, medications, or health status.

Annual medical updates are required to ensure ongoing safety and clinical appropriateness.

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Consultation Fee & Validity

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• Nurse Practitioner consultations are fee-based

• Current fee for a telemedicine NP consultation: $35

• Consultation is valid for 12 months, provided no significant changes occur in medical history

• NP consultation fees are not eligible for promotions, vouchers, or coupons

• Consultations are limited to 15 minutes

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Telemedicine Acknowledgment & Consent

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By choosing a telemedicine consultation, you acknowledge and agree that:

• The consultation will be conducted remotely using secure telehealth technology

• Telemedicine has limitations compared to in-person evaluations

• The Nurse Practitioner may determine that an in-person visit or additional testing is required before clearance is granted 

• Medical clearance is not guaranteed

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• Medical Clearance & Booking

• Once medical eligibility is confirmed by the Nurse Practitioner:

• You may proceed to the Bookings page

• Select the appropriate service category

• Complete your appointment booking

• You will receive email confirmation

• Please review all pre- and post-service guidelines prior to your appointment

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• Important Medical Disclosure​

• The Pout Medical Aesthetics provides services focused on wellness, prevention, and elective medical aesthetics.

• We do not diagnose or treat disease, nor do we provide emergency or trauma care.
  Participation in services is voluntary and elective.

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• Privacy & HIPAA Notice (Corrected & Compliant)

• Your privacy is important to us.

• All medical consultations are conducted in accordance with applicable HIPAA privacy standards

• Your protected health information is safeguarded and used only for treatment, payment, and healthcare operations

• Telemedicine platforms used by The Pout Medical Aesthetics are selected with patient privacy in mind

• By proceeding, you acknowledge receipt and understanding of this notice and consent to care as described.