Last updated: June 5, 2026
Telehealth services (virtual appointments) offered through Promeniq and its affiliated clinic brands are not designed for emergency or urgent medical care.
If you believe you are experiencing a medical emergency, call 911 or go to the nearest emergency department immediately.
If you are experiencing chest pain, severe shortness of breath, symptoms of stroke, severe allergic reaction, suicidal thoughts, a mental health crisis, or any other urgent or life-threatening condition, do not use telehealth, online scheduling, messaging, chat, email, or text communication to seek care. Call 911 or seek emergency medical attention immediately.
This Telehealth Informed Consent & Disclosure explains how telehealth services may be provided by Promeniq-affiliated clinic brands, including:
This Consent describes:
This Consent supplements, but does not replace:
Promeniq supports a network of affiliated men’s health and lifestyle health clinic brands. Medical care is provided by licensed healthcare providers employed by or affiliated with the applicable clinic brand in the state where services are available.
Promeniq-affiliated providers may include, as permitted by law:
Clinical decisions are made by licensed healthcare providers exercising independent medical judgment within the scope of their licensure and applicable law.
Promeniq, its affiliated clinic brands, administrative staff, technology vendors, scheduling tools, and patient support teams do not guarantee that any patient will receive a diagnosis, treatment, prescription, refill, laboratory order, or specific medical outcome.
Promeniq-affiliated clinic brands may provide telehealth services only where legally permitted and operationally available.
Promeniq-affiliated services may be available in some or all of the following states:
Availability may vary by clinic brand, provider licensure, patient location, service type, treatment type, pharmacy availability, laboratory availability, and applicable state or federal law.
You may be asked to confirm your location at the time of scheduling, intake, or consultation. Your provider may be required to be licensed or otherwise legally permitted to provide care in the state where you are located at the time of the telehealth encounter.
Some states may require specific disclosures, consent language, documentation, provider information, complaint information, or other patient notices. State-specific requirements may be provided separately or incorporated into this Consent where applicable.
Telehealth may be used for services offered by Promeniq-affiliated clinic brands where medically appropriate and legally permitted, including but not limited to:
Not every service can be provided through telehealth. Your provider may determine that telehealth is not appropriate for your condition, symptoms, requested treatment, medical history, medications, lab results, or safety needs.
Telehealth, or Virtual Appointment, is the delivery of healthcare services using electronic communications when the patient and provider are not in the same physical location.
Telehealth may include:
By using telehealth services, you understand that your provider may not be physically present with you and may not be able to perform the same type of physical examination that may be available during an in-person visit.
By checking a box, clicking “I agree,” electronically signing, submitting a telehealth intake form, booking a telehealth appointment, participating in a telehealth visit, or otherwise affirmatively accepting this Consent, you acknowledge and agree that:
You may withdraw your consent to receive telehealth services at any time by notifying your care team, subject to applicable law and any actions already taken in reliance on your consent.
Withdrawing consent to telehealth may limit or prevent Promeniq-affiliated providers from continuing to provide certain services remotely.
Telehealth may provide potential benefits, including:
These benefits are not guaranteed and may vary by patient, provider, service type, technology, location, and applicable law.
Alternatives to telehealth may include:
You may choose an alternative to telehealth at any time.
You understand that telehealth has limitations. These may include:
If your provider determines that telehealth is not appropriate, your provider may discontinue the telehealth encounter, recommend an in-person visit, require additional testing, refer you to another provider, recommend urgent or emergency care, or decline to prescribe medication.
Potential risks of telehealth include, but are not limited to:
No specific medical outcome, symptom improvement, treatment response, or result is guaranteed.
Telehealth involves the electronic transmission of health information. Promeniq-affiliated clinic brands use administrative, technical, and physical safeguards intended to protect patient information consistent with applicable privacy practices and laws.
However, no electronic communication system can be guaranteed to be completely secure.
To help protect your privacy, you agree to:
Your health information may be used or disclosed for treatment, payment, healthcare operations, care coordination, pharmacy services, laboratory services, legal compliance, and other purposes described in the applicable Privacy Policy or Notice of Privacy Practices.
This Consent should be read together with the applicable Privacy Policy or Notice of Privacy Practices.
Promeniq-affiliated providers and care teams may rely on information you provide, including:
You understand that providers may not have access to your complete medical history. Incomplete, outdated, inaccurate, or omitted information may affect clinical decisions, treatment recommendations, medication safety, and the appropriateness of telehealth care.
You agree to provide truthful, accurate, and complete information and to update your care team if your health, medications, symptoms, or treatment status changes.
Promeniq-affiliated clinic brands may use automated scheduling, intake, routing, chat, or AI-enabled tools to help patients request appointments, provide information, submit questions, or connect with the appropriate care team.
These tools may help with scheduling, routing, general information, and administrative support. They are not medical providers.
You understand and agree that automated tools:
Patients may choose to disclose symptom information, health concerns, or other personal information through scheduling or chat tools. Information you submit may be used for scheduling, care coordination, routing, follow-up, or preparation for your consultation, as permitted by applicable law and privacy practices.
If you believe you are experiencing an urgent or emergency medical condition, do not use automated tools, chat, website forms, email, or text messaging. Call 911 or seek emergency medical care immediately.
Telehealth may not be appropriate for every patient, condition, or treatment request.
Your provider may determine that telehealth is not appropriate if, for example:
If telehealth is not appropriate, you may be advised to seek in-person care, urgent care, emergency care, specialty care, laboratory testing, or additional evaluation before treatment decisions are made.
Participation in a telehealth consultation does not guarantee that:
Prescribing decisions are made by licensed providers based on medical judgment, patient safety, patient eligibility, applicable clinical standards, pharmacy requirements, and state and federal law.
If medication is prescribed, prescriptions may be filled and shipped by partner pharmacies, including licensed 503A compounding pharmacies where applicable. Medication shipping, timing, availability, pricing, and fulfillment may vary.
Certain medications may have special legal, clinical, pharmacy, laboratory, follow-up, or safety requirements. Certain medications, including controlled substances, may be subject to additional state or federal restrictions and may not be available through telehealth in all circumstances.
You may ask whether use of a pharmacy of your choice is available, subject to legal, clinical, pharmacy, operational, and practical constraints.
Some therapies offered through Promeniq-affiliated clinic brands may involve compounded medications.
Compounded medications are prepared by licensed compounding pharmacies based on a prescription from a licensed provider. Compounded medications are not the same as FDA-approved drug products and may not be evaluated by the FDA for safety, effectiveness, or quality.
Treatment-specific disclosures may be required for certain compounded medications, including but not limited to GLP-1 medications, hormone-related medications, peptides, ED medications, and other therapies.
Your provider will determine whether any compounded medication may be appropriate for you based on your health history, clinical needs, and applicable law.
Some services may require laboratory testing, review of prior lab results, vital signs, medical records, imaging, or other diagnostic information before treatment is started, changed, renewed, or continued.
Laboratory testing may include:
If laboratory testing is required and you do not complete it, your provider may be unable to diagnose, treat, prescribe, refill, continue, or adjust therapy.
Laboratory testing may involve risks, including discomfort, bruising, bleeding, lightheadedness, fainting, infection, false positive results, false negative results, inconclusive results, delayed results, or lab processing errors.
Third-party laboratories are independent entities. Promeniq-affiliated clinic brands do not guarantee the accuracy, reliability, timing, availability, or completeness of third-party laboratory services.
You are responsible for following laboratory instructions and informing your provider of any relevant outside test results or medical findings.
Some communications may occur asynchronously, meaning you and your provider or care team are not communicating at the same time.
Asynchronous communication may include:
These communication channels may not be monitored continuously. Response times are not guaranteed.
Do not use asynchronous communication for urgent or emergency medical needs. If you believe you need urgent or emergency care, call 911 or seek emergency medical attention immediately.
You agree to:
Failure to provide accurate or complete information may affect clinical decisions and could create risks to your health and safety.
Telehealth consultation does not guarantee diagnosis, treatment, prescription, refill, medication availability, symptom improvement, weight loss, sexual health improvement, hormone optimization, or any specific result.
Individual response to treatment varies. Results are not guaranteed.
Your provider will determine whether treatment is appropriate based on your health history, goals, symptoms, labs, medications, contraindications, applicable law, and clinical judgment.
Telehealth services offered through Promeniq-affiliated clinic brands are intended for adults only.
By using telehealth services, you represent that you are at least 18 years old or the age of majority required for the applicable service in your state, whichever is greater.
Telehealth services are not intended for minors unless expressly permitted by the applicable clinic brand, provider, and law.
Telehealth visits are not recorded unless you are notified in advance and consent is obtained, or recording is otherwise permitted by applicable law.
You may not record telehealth visits without provider permission where required by law.
Certain services may require additional treatment-specific informed consent before care is provided. These may include, but are not limited to:
This Telehealth Consent does not replace treatment-specific informed consent.
For informational purposes, federal law requires certain manufacturers of drugs, medical devices, and biologics to report payments and other transfers of value made to physicians and teaching hospitals. This information is available through the federal Open Payments database maintained by the Centers for Medicare & Medicaid Services.
Patients may search the Open Payments database for information about payments made by applicable manufacturers to physicians and teaching hospitals.
You may withdraw your consent to receive telehealth services by notifying your care team in writing or by discontinuing use of telehealth services, subject to applicable law.
Withdrawal of consent will not affect actions already taken in reliance on your prior consent.
If you withdraw consent, Promeniq-affiliated providers may be unable to continue providing certain services remotely and may advise you to seek in-person care or another provider.
This Consent may be updated from time to time. The version in effect at the time of your telehealth encounter or acceptance governs your use of telehealth services unless otherwise required by law.
Material updates may be posted online, included in intake workflows, or otherwise made available to you.
By checking the consent box, clicking “I agree,” electronically signing, submitting an intake form, booking a telehealth appointment, participating in a telehealth visit, or otherwise affirmatively accepting this Consent, you acknowledge and agree that:
For questions about telehealth services, privacy practices, or this Consent, please contact:
Promeniq
Jeff Dillon, CEO
1780 South Bellaire Street, Suite 355
Denver, CO 80222
For clinic-specific questions, please contact the applicable Promeniq-affiliated clinic brand:
Tri-State Men's Health
