TELEHEALTH CONSENT

TriArc Rx and/or its affiliates or subsidiaries (collectively, “Company,” “we,” or “us”) owns and operates the website located at https://triarcrx.com/, and any mobile application related thereto, to provide certain TriArc Rx products and services (collectively, the “Service”). Your access and use of the Service requires your consent to the use of telehealth to provide the Services.

PURPOSE

The purpose of this consent (“Consent”) is to provide you with information about telehealth and to obtain your informed consent to the use of telehealth in the delivery of TriArc Rx services to you by certain TriArc Rx personnel (“Providers”). In this Consent, the terms “you” and “yours” refer to the person using the Service.

BY CLICKING “I AGREE,” CHECKING A RELATED BOX TO SIGNIFY YOUR ACCEPTANCE, USING ANY OTHER ACCEPTANCE PROTOCOL PRESENTED THROUGH THE SERVICE, OR BY USING TELEHEALTH DURING THE USE OF THE SERVICE, 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.

USE OF TELEHEALTH

Telehealth involves the delivery of TriArc Rx services using electronic communications, information technology, or other means between a TriArc Rx 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;

• Interactions between a patient and provider via audio, video, and/or data communications; or

• Use of output data from medical devices, sound, and video files.

POTENTIAL RISKS

There may be 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, 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, produce incorrect records, transmissions, data, or content, or cause records, transmissions, data, or content to be corrupted or lost.

• Your Provider(s) may not be able to provide treatment for your requested service.

• Deficiencies or failures of the technology or electronic equipment used.

• The electronic systems or other security protocols or safeguards used could fail, causing a breach of privacy of your medical or other information.

• Data stored and communicated electronically may be more susceptible to unintended disclosure of protected health information to third parties.

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. Use of the Service may include email communications to and from you that may include your protected health information. You understand that the Company does not and cannot guarantee the security or privacy of the services you use to receive communications, including your email service provider.

ACKNOWLEDGMENTS

You have the right to withdraw your consent to the use of telehealth at any time; however, our Providers solely use telehealth to provide the TriArc Rx services and you will need to seek treatment from another provider after you withdraw your consent. Any withdrawal of your consent will be effective upon receipt of written notice to your Providers. Any withdrawal of your consent will not affect any other provision of this Consent, and you will continue to be bound by this Consent.