Telehealth Informed Consent

What our telehealth service is

HAIRMDL® provides hair-loss care through asynchronous telehealth, sometimes called “store-and-forward.” You complete a medical questionnaire online. A physician licensed in your state reviews your answers and, if they decide treatment is medically appropriate, writes a prescription for a compounded topical hair-loss formulation. A licensed compounding pharmacy fills the prescription and ships it to you. The physician may contact you by email, text, or phone if they have questions, and you may contact our clinical team at any time.

There is usually no live video or phone visit. The physician’s decision is based on the information you provide, so it is important that your answers are complete and accurate.

Who can use the service

• You must be 18 years of age or older.
• You must be physically located in a state where we operate at the time you complete the questionnaire. We currently serve New Jersey, New York, Florida, Pennsylvania, Connecticut, and Texas.
• You must be completing the questionnaire for yourself, not for another person.

Benefits and limitations

Telehealth lets you get a physician’s review and, when appropriate, a prescription without an in-person appointment. It also has limits you should understand:

• The physician cannot perform a physical examination of your scalp. Hair loss can have causes that need in-person evaluation, lab work, or a biopsy. The physician may decline to prescribe and recommend that you see a dermatologist or your primary care provider.
• Information you omit or state inaccurately may lead to a treatment decision that is not right for you.
• Technology can fail. Delays, outages, or transmission problems may interrupt or delay your care. In rare cases, security protections could fail and your information could be accessed without authorization. We use encryption and access controls to reduce this risk, as described in our Notice of Privacy Practices.
• Our service treats hair loss only. It does not replace a primary care provider or a dermatologist for other conditions.

About the medication

If prescribed, your treatment is a compounded topical solution or foam made for you by a licensed compounding pharmacy. Depending on your formula it may contain minoxidil, dutasteride, latanoprost, tretinoin, caffeine, and triamcinolone, and on some product lines, exosome-derived ingredients. Compounded medications are prepared under state pharmacy law and are not FDA-approved products; the FDA does not review their safety or effectiveness.

Common side effects of these ingredients include scalp irritation, dryness, redness, or itching; a temporary increase in shedding during the first weeks of use; and unwanted hair growth where the product touches other skin. Less common effects can include dizziness, rapid heartbeat, or swelling (minoxidil); changes in sexual function or mood (dutasteride); darkening of skin or, if the product contacts the eye, changes to eyelash or iris color (latanoprost); increased sun sensitivity (tretinoin); and thinning of the skin with prolonged use (triamcinolone). Stop using the product and contact us or your physician if you experience side effects that concern you.

Do not use a formula containing dutasteride if you are pregnant, breastfeeding, or may become pregnant, and do not let a person who is pregnant handle it. Tell us about every medication, supplement, allergy, and medical condition so your physician can check for interactions. Results vary, and no treatment works for everyone. Full warnings for each ingredient are on our Drug Safety Information page.

Your responsibilities

• Answer every question truthfully and completely.
• Tell us promptly if your health, medications, or pregnancy status change, or if you experience side effects.
• Use the medication only as directed, and only for yourself. Do not share it.
• Keep your account email and phone number current so your physician and our team can reach you.
• Seek in-person care when we recommend it.

Your records and privacy

Your questionnaire, the physician’s review, and your prescription history form your medical record with us. They are stored securely, shared only with the physician reviewing your case, the pharmacy filling your prescription, and the staff who support you, and are retained for the period required by law. Our Notice of Privacy Practices explains how your information is used and your rights to access it.

Fees and refunds

The price you pay covers the physician review, the compounded medication, and shipping. You are charged when you place your order. If your physician decides not to prescribe, your order is refunded in full. Our Refund Policy covers other situations. We do not bill health insurance.

Your right to withdraw

You may stop using our service at any time by not completing the questionnaire, cancelling your subscription from your account, or contacting us at support@hairmdl.com or (877) 424-7635. Withdrawing your consent does not affect care already provided or prescriptions already dispensed.

Questions and complaints

Questions about this consent or your care can be sent to support@hairmdl.com or (877) 424-7635. Our physicians are licensed by the medical board of each state in which they practice; you may contact your state’s medical board with any complaint about a physician.

Your consent

By checking the consent box at the end of your questionnaire, you confirm that:

• You have read and understand this Telehealth Informed Consent.
• You have received and reviewed our Notice of Privacy Practices.
• You understand the benefits, risks, and limitations of receiving care by asynchronous telehealth, and that the physician may decline to prescribe.
• You are 18 or older, located in a state we serve, and completing the questionnaire for yourself.
• You voluntarily consent to receive hair-loss care from HAIRMDL® physicians by telehealth.

We record the date and time you give consent, and the version of these documents in effect, as part of your medical record.