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Telehealth Consent

AUTHORIZATION TO USE AND DISCLOSE MY MEDICAL INFORMATION AND CONSENT TO TELEHEALTH

OPEN PAYMENTS NOTICE

Last updated: June 19, 2026

BY CLICKING “I AGREE,” CHECKING A RELATED BOX TO SIGNIFY YOUR ACCEPTANCE, USING ANY OTHER ACCEPTANCE PROTOCOL PRESENTED THROUGH THE SERVICE OR OTHERWISE AFFIRMATIVELY ACCEPTING THIS CONSENT, YOU ACKNOWLEDGE THAT YOU HAVE READ, ACCEPTED, AND AGREED TO BE BOUND BY THIS CONSENT. IF YOU DO NOT AGREE TO THIS CONSENT, DO NOT CREATE AN ACCOUNT OR USE THE SERVICE.

IF YOU ARE EXPERIENCING A LIFE-THREATENING SITUATION SUCH AS CONTEMPLATING SUICIDE, CALL 911 OR THE 988 SUICIDE & CRISIS LIFELINE AT 988.

INFORMED CONSENT REGARDING USE OF TELEHEALTH

PURPOSE: The purpose of this consent form (“Consent”) is to provide you with information about telehealth and to obtain your informed consent to the use of telehealth in the delivery of healthcare services to you by physicians, physician assistants, nurse practitioners, and/or other licensed health professionals (“Providers”) using the online platforms owned and operated by Genecis Bio Inc. and/or its subsidiaries (the “Service”). This Service is intended for adults aged eighteen (18) and over.

USE OF TELEHEALTH

Telehealth involves the delivery of healthcare services using electronic communications, information technology or other means between a healthcare provider and a patient who are not in the same physical location. Telehealth may be used for diagnosis, treatment, follow-up and/or patient education, and may include, but is not limited to, one or more of the following: electronic transmission of medical records, photo images, personal health information or other data between a patient and a provider; interactions between a patient and provider via audio, video and/or data communications (such as messaging or email communications). Alternative methods of care may be available to you, such as in-person services, and you may choose an alternative at any time.

ANTICIPATED BENEFITS

The use of telehealth may have the following possible benefits: making it easier and more efficient for you to access medical care or other services and treatment for the conditions treated by your Provider(s); allowing you to obtain medical care or other services and treatment by Provider(s) at times that are convenient for you; and enabling you to interact with Provider(s) without the necessity of an in-office appointment.

POTENTIAL RISKS

While the use of telehealth in the delivery of care can provide potential benefits for you, there are also potential risks associated with the use of telehealth and other technology. These risks include, but may not be limited to the following:

  • The quality, accuracy or effectiveness of the services you receive from your Provider could be limited.
  • Technology may contain bugs or other errors, including ones which may limit functionality, produce erroneous results, or render part or all of such technology unavailable or inoperable.
  • Failures of technology may also impact your Provider(s) ability to correctly diagnose or treat your condition.
  • The inability of your Provider(s) to conduct certain tests or assess vital signs in-person may in some cases prevent the Provider(s) from providing a diagnosis or treatment or from identifying the need for emergency medical care.
  • Your Provider(s) may not be able to provide treatment for your particular condition and you may be required to seek alternative healthcare or emergency care services.
  • Delays in medical evaluation/treatment could occur due to unavailability of your Provider(s) or deficiencies or failures of the technology used.
  • The electronic systems or other security protocols could fail, causing a breach of privacy of your medical or other information.
  • Given regulatory requirements in certain jurisdictions, your Provider(s) diagnosis and/or treatment options, especially pertaining to certain prescriptions, may be limited.

LIFE THREATENING AND OTHER EMERGENCY SITUATIONS; FOLLOW-UP CARE

IF YOU ARE EXPERIENCING A LIFE-THREATENING SITUATION SUCH AS CONTEMPLATING SUICIDE, CALL 911 OR THE 988 SUICIDE AND CRISIS LIFELINE AT 988.

If the situation is an emergency, call 911. In some situations, telehealth is not an appropriate method of care. If you require immediate or urgent care, you must seek care at an emergency room facility or other provider equipped to deliver urgent or emergent care.

If a technical failure prevents you from communicating with your Providers through the Service, you should call the following number: Phone: 1 (866) 525-3777 (M-F 9AM – 5PM).

DATA PRIVACY AND PROTECTION

The electronic systems used in the Service will incorporate network and software security protocols to protect the privacy and security of your information and will include measures to safeguard data against intentional or unintentional corruption. Personal information that identifies you or contains protected health information will not be disclosed to any third party without your consent, except as authorized by law for the purposes of consultation, treatment, payment/billing, certain administrative purposes, and as required by law.

LABORATORY PRODUCTS AND SERVICES

Certain healthcare services provided to you by Providers via the Service may include laboratory testing. If laboratory tests are ordered, they may be provided by affiliated and/or third-party laboratories, and neither Genecis Bio Inc. nor your Provider(s) can guarantee the accuracy or reliability of these tests. These laboratory tests can provide false negative, false positive, or inconclusive results.

You understand that laboratory testing is voluntary and you may choose not to have your sample tested. You have read and understand the information provided in this consent, and all your questions have been answered. You acknowledge that the information provided by you to the Service is true and correct.

OPEN PAYMENTS NOTICE

For informational purposes only, a link to the federal Centers for Medicare and Medicaid Services Open Payments web page is provided here. The federal Physician Payments Sunshine Act requires that detailed information about payment and other payments of value worth over ten dollars ($10) from manufacturers of drugs, medical devices, and biologics to physicians and teaching hospitals be made available to the public. The Open Payments database is a federal tool used to search payments made by drug and device companies to physicians and teaching hospitals. It can be found at https://openpaymentsdata.cms.gov.

YOUR ACKNOWLEDGMENTS

By clicking “I Agree”, checking a related box to signify your acceptance, or using any other acceptance protocol presented through the Service, you are agreeing and providing your consent with respect to the following:

  • Healthcare services provided to you by Providers via the Service will be provided by telehealth. In some cases, your treating Provider may be a nurse practitioner or physician assistant and not a physician, and you agree to be treated by non-physician providers, if applicable, by using the Service.
  • Technology used to deliver care, including the Service, may contain bugs or other errors, including ones which may limit functionality, produce erroneous results, render part or all of such technology unavailable or inoperable, or cause records, transmissions, data or content to be corrupted or lost, any or all of which could limit or otherwise impact the quality, accuracy and/or effectiveness of the medical care you receive from your Provider(s).
  • No potential benefits from the use of telehealth or specific results can be guaranteed. Your condition may not be cured or improved, and in some cases, may get worse.
  • You have the opportunity to discuss the use of telehealth, including the Service, with your Provider(s), including the benefits and risks of such use and the alternatives to the use of telehealth.
  • You understand that there will be no recording of any online treatment sessions by your Provider(s) or you.
  • You have the right to withdraw your consent to the use of telehealth in the course of your care, without prejudice to any future care or treatment. Any withdrawal of your consent will be effective upon receipt of written notice to your Providers.
  • You understand that it is your duty to provide Journi Health and your Provider(s) truthful, accurate and complete information, including all relevant information regarding care that you may have received or may be receiving from other healthcare providers.
  • Journi Health has commercial relationships with the Pharmacies and Labs that fulfill prescriptions and laboratory services ordered through the Platform. Journi Health has a financial relationship with the entity that employs or contracts with your Provider. You are free to obtain your medical examination from another healthcare provider that is not associated with Journi Health. You are free to obtain your prescription from any pharmacy of your choice by contacting our support team.
  • You must pay the full amount of the costs associated with use of the Service, including any prescription you may receive, and you will not attempt to submit a claim to Medicare, any other federal payor, or any state or private insurer.

If you have a concern about a medical professional, you may contact the Medical Board in your state regarding your concerns.

GENECIS BIO INC.