Patient Intake — Teck Wellness

Step 1 of 6Consent

Consent

Before we begin, please review and accept the consent notice below.

Please review and check each of the 8 items below. All boxes must be checked before you can begin the screening.

1.I understand Teck Wellness is not a healthcare provider and my result is not a medical diagnosis.2.I consent to Teck Wellness collecting my health information for GLP-1 eligibility screening.3.I consent to Teck Wellness using and sharing my information as described in the Privacy Policy.4.I acknowledge that I have been informed of my HIPAA rights.5.I understand my participation is voluntary and I may withdraw at any time.6.I agree to provide accurate and truthful information in this screening.7.I understand this platform is not for emergencies — I will call 911 for medical emergencies.8.I have read and agree to the Terms of Service and Privacy Policy.

Please review and check all 8 items to continue.