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Telemedicine Consent

Clynix BioMed Testing, Telemedicine & Rapid Care

Telemedicine Consent Policy

Consent to Telemedicine 

Services

Telemedicine involves the use of electronic communications to enable healthcare

providers to deliver services remotely.

By using telemedicine services through Clynix, you acknowledge and consent to the following:

Understanding of Telemedicine

  • Telemedicine may include video, phone or electronic communications

  • Limitations exist compared to in-person visits

  • Technology failures may occur

Benefits

  • Convenient access to care

  • Reduced travel and wait times

  • Continuity of care

Risks

  • Technical difficulties

  • Incomplete transmission of information

  • Privacy risks despite safeguards

Patient Responsibilities

  • Provide accurate medical information

  • Ensure a private and secure environment

  • Follow provider recommendations

Consent

By proceeding with telemedicine services, you voluntarily consent to receive care via 

telemedicine.

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) 202-0898

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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