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Minor & Guardian Consent Policy

PARENT/GUARDIAN AUTHORIZATION FOR TREATMENT

Patients under the age of 18 must have consent of a parent or legal guardian before receiving medical services through Clynix Health, including telemedicine consultations, diagnostic services, and other healthcare services.

CONSENT REQUIREMENTS

  • A parent or legal guardian must provide consent before treatment is rendered. 

  • The parent or guardian may be required to provide identification and documentation verifying legal guardianship.

  • Telemedicine appointments involving minors may require the parent or guardian to be present during the consultation unless otherwise permitted by law.

HEALTHCARE DECISIONS

The parent or legal guardian acknowledges that they are authorized to make healthcare decisions on behalf of the minor patient and consent to evaluation, treatment and communication regarding the minor’s healthcare needs.

PRIVACY & CONFIDENTIALITY

Clynix Health will protect patient information in accordance with HIPAA regulations and applicable  federal and state laws.  Certain healthcare services may be subject to additional privacy protections as required by law. 

QUESTIONS​

For questions regarding consent requirements for minor patients, please contact Clynix Health prior

to scheduling an appointment.

Office Hours

Monday-Friday: 9am to 6pm

Saturday: 9am to 4pm

Sunday: Closed

 

Clynix BioMed Testing, Telemedicine & Rapid Care

Address:

105 Vulcan Road Suite 110

Homewood, Al. 35209

Email: support@clynixhealth.com

Phone: (205) 222-1827

Clynix BioMed Testing & Telemedicine

General Patient Intake Form


Patient Demographics

Birthday
Month
Day
Year

Home Address (Required For Telemedicine)

Emergency Contact

Telemedicine Location Confirmation

I confirm that I am physically located in the following state at the time of my telemedicine visit:


Preferred Pharmacy

Insurance & Payment Selection

Acknowledgement


I certify that the information provided above is accurate and complete to the best of my knowledge.

© 2026 by Clynix BioMed Testing, Telemedicine & Rapid Care

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