For Majesta Health patients

Telehealth Informed Consent

Please read this consent carefully before completing your medical assessment. You will be asked to confirm your agreement in writing before a licensed physician reviews your file.

Version v1.0-2026-05-23 · Last reviewed: May 23, 2026

1. Nature of telehealth services

Majesta Health LLC (“Majesta”) operates a telehealth technology platform that connects patients in the United States with independently licensed healthcare providers (“Providers”) for the evaluation and, when clinically appropriate, treatment of overweight and obesity using GLP-1 receptor agonist medications. Telehealth services include the electronic exchange of medical information through secure messaging, asynchronous questionnaires, store-and-forward review of clinical information, and audio or video consultations when clinically indicated.

Majesta is not a medical practice, pharmacy, or insurer. Majesta does not itself diagnose, treat, or prescribe medication. All clinical decisions are made by Providers in the exercise of their own independent professional judgment, applying the standard of care in your state of residence.

2. Potential benefits of telehealth

  • Access to a US-licensed physician without an in-person clinic visit, including in areas where weight-management specialists are scarce or have long waitlists.
  • Faster initial review and follow-up than typical in-person scheduling.
  • Continuity of care with the same Provider for follow-up questions, side-effect management, and dose adjustments.
  • Coordinated dispensing of medication, when prescribed, by a state-licensed compounding pharmacy that ships directly to your address.

3. Risks and limitations of telehealth

Although telehealth offers many benefits, it also has limitations. You acknowledge the following:

  • A Provider performing a remote evaluation may not have access to all of the information that would be available during an in-person visit. This may, in some cases, affect the Provider's clinical decision-making.
  • Technology failures, including network outages, software errors, or device problems, may delay or interrupt the delivery of care.
  • Despite reasonable security measures, electronic transmission of health information carries an inherent risk of unauthorized access. Majesta and its Providers maintain administrative, physical, and technical safeguards designed to protect the confidentiality of your health information, as described in our HIPAA Notice of Privacy Practices.
  • GLP-1 medications carry known risks, including but not limited to nausea, vomiting, diarrhea, constipation, hypoglycemia, dehydration, gallbladder disease, pancreatitis, acute kidney injury, and, in animal studies, thyroid C-cell tumors. Your Provider will review these and other risks with you before prescribing.
  • Compounded medications are not FDA-approved as final products. The active pharmaceutical ingredient is FDA-registered, and compounded preparations are prepared by a state-licensed compounding pharmacy under section 503A of the Federal Food, Drug, and Cosmetic Act. Compounded preparations are not interchangeable with their FDA-approved branded counterparts.
  • A prescription is not guaranteed. After reviewing your assessment, your Provider may determine that GLP-1 treatment is not clinically appropriate for you.

4. Alternatives to telehealth

You have the right to seek care from an in-person provider at any time. Reasonable alternatives to telehealth include consulting your primary care physician, an obesity-medicine specialist, an endocrinologist, or a hospital-based weight management program. The decision to use telehealth services is voluntary, and you may withdraw your consent at any time without affecting your right to future care.

5. Prescribing and the Ryan Haight Act

The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 and applicable state laws govern prescribing through telehealth. Providers on the Majesta platform prescribe only non-controlled medications for the treatment of overweight and obesity. Providers must be licensed in the state where you are physically located at the time of the encounter and may decline to prescribe if doing so would violate federal or state law or their professional judgment.

The medications prescribed through this service may include compounded semaglutide and compounded tirzepatide. They are non-controlled prescription medications, and you must have a valid prescription from a licensed Provider to receive them.

6. Emergencies and after-hours care

Majesta is not designed for emergencies. If you believe you are experiencing a medical emergency, including severe abdominal pain, difficulty breathing, signs of an allergic reaction, severe dehydration, signs of pancreatitis, chest pain, stroke symptoms, or suicidal thoughts, call 911 immediately or go to the nearest emergency department. For urgent but non-emergency clinical questions, you may contact your Provider through the patient portal; most non-urgent replies arrive within 24 hours.

7. Security and patient privacy

Majesta and its Providers maintain administrative, physical, and technical safeguards designed to protect the confidentiality and integrity of your protected health information (PHI) in accordance with the Health Insurance Portability and Accountability Act (HIPAA). Majesta does not disclose PHI to third-party advertising or analytics platforms without your authorization. For complete details, see our HIPAA Notice of Privacy Practices and our Privacy Policy.

Telehealth encounters are not routinely recorded. If a recording is necessary for clinical or compliance reasons, your Provider will obtain your consent in advance. Your medical records are retained for the period required by law and the applicable state medical board.

8. Patient responsibilities

By using the Services, you agree that:

  • You are at least 18 years of age and a US resident. Majesta does not provide services to minors.
  • You will provide complete, accurate, and current health information. Withholding or misrepresenting information may endanger your safety and may result in termination of the patient-provider relationship.
  • You will follow your Provider's instructions, take medication as prescribed, and contact your Provider promptly with side effects or new symptoms.
  • You will use the Services for yourself only and will not share your medication with another person.

9. Right to withdraw consent

You may withdraw your consent to telehealth services at any time by emailing support@majestahealth.com or by canceling your subscription in your patient portal. Withdrawal of consent does not affect any care already provided.

10. Complaints and state medical board contact

If you have a complaint regarding the clinical care provided by a Provider, you may contact support@majestahealth.com. You also retain the right to file a complaint with the state medical board where your Provider is licensed. Contact information for each state medical board is available on our states page.

11. Acknowledgment

By checking the consent box during the clinical assessment, you acknowledge that:

  • You have read and understood this consent in full.
  • You have had the opportunity to ask questions and to consult with a healthcare provider of your choice before agreeing.
  • You voluntarily consent to receive telehealth services from Providers on the Majesta platform.
  • You understand that consent is not a guarantee that treatment, prescription, or any particular outcome will be provided.

A copy of the version of this consent that you agreed to, together with a timestamp, will be retained in your patient record for compliance and audit purposes.

12. Contact information

Majesta Health LLC
30 N Gould St #11161, Sheridan, WY 82801
Phone: (307) 396-6646
Email: support@majestahealth.com