Consent to Telehealth Treatment
Effective March 11th, 2022

Please read this Consent to Treatment, as well as our Terms of Service (the “Terms“) and Privacy Policy (“Privacy Policy“) carefully because they govern your use of the website located at (the “Site“) and access to virtual medical care and coordination of related services accessible via the Site offered by Tono, Inc. (“Tono“, “we“, or “us“). To make these Terms easier to read, the Site and our services are collectively called the “Services.“

1. Introduction:

Telehealth (or Telemedicine, often these terms are used interchangeably) involves the real- time evaluation, diagnosis, consultation, and treatment of a health condition using advanced telecommunication technology, which often includes the use of interactive audio, video, or other electronic media. The use of telehealth technology allows a physician or other health care provider to see and communicate with you, the patient, in real-time from a remote or distant location.

2. Consent for Telehealth-Based Treatment:

You consent to receive medical care, including diagnosis, consultation, and/or treatment, from Tono Medical Services, P.C. and other medical practices (together, the “Providers“) using remote, electronic communications, such as interactive chat, audio, and/or video communications enabled through the Site and our Services. You agree to be treated via a virtual visit with a physician or other health care provider (i.e., not an in-person visit) and understand that there are inherent risks and limitations associated with a virtual visit with a physician or other health care provider, including, but not limited to, risks and limitations arising from such physician’s or medical provider's ability, or inability, to comprehensively assess and accurately diagnose illness, injury, disease, or other medical issues using remote, electronic communications. You understand that Providers using our Site will not have the opportunity to perform an in-person physical examination of you at the time my telehealth services are provided; and will rely on information provided by you before and during the telehealth services encounter.

You understand that a Provider's advice, recommendations, and/or decisions may be based on factors not within their control, such as incomplete or inaccurate data provided by you or distortions of diagnostic images or specimen that may result from electronic transmission issues. You understand that you must provide information about your medical history, condition(s), and current or previous medical care that is complete and accurate to the best of your knowledge and ability. You also understand that in the event the telehealth services are interrupted due to a technology problem or an equipment failure, alternative means of communication may be implemented and/or an in-person medical evaluation with your regular treating physician may be necessary.

If you experience any urgent medical symptoms or conditions, you will consult your regular treating physician or, in the case of an emergency, dial 911 or go directly to the nearest emergency room.

If you have any questions about the telehealth services to be provided to you, including any relevant risks and hazards involved with the provision of such services, please ask your Provider or contact customer service (

3. Your Financial Responsibility; Assignment of Benefits

You agree to pay Tono all applicable charges at the prices then in effect for the Medical Services provided to you or another person on whose behalf you are accepting these telehealth consent for medical services Terms and/or payment responsibility. You will be charged for the Medical Services, including complementary and alternative services provided to you by a Tono provider (each, a “Provider”). You authorize Tono to charge your chosen payment method (your "Payment Method") for the Medical Services provided to you. If your Payment Method is invalid at the time payment is due, you agree to pay all amounts due upon demand. The third party services provider who manages your Payment Method may impose terms and conditions on you, which are independent of these Medical Services Terms, and you agree to comply with all of those terms. Tono may accumulate charges that you’ve incurred for the Medical Services and submit them as one or more aggregate charges during or at the end of each billing cycle. Tono reserves the right to correct any billing errors or mistakes even if payment has already been requested or received.

Medical Services include remote visits with our providers. Remote visits are scheduled just like an in-office visit and provide the same service experience, with the exception that the remote visit is conducted remotely over a secure video and audio connection rather than in person. Remote visits are billable just like an in-office visit, at the same fee that would be billed to such a visit if it was conducted in person. For the avoidance of doubt, your financial responsibility and assignment of benefits described above apply to remote visits as well.

If you provide information about your health insurance or health plan, that will be deemed your authorization for us to submit claims for covered Medical Services to your health insurer or health plan. You hereby assign or otherwise authorize payment of medical benefits to us for the Medical Services provided to you. You authorize the release of any medical or other information necessary to process any claims for the Medical Services provided. You request payment of government benefits to be assigned to Tono and it's affilate medical practices. Your Further assign payment of medical benefits to your Tono physician for the medical care and services received on the platform. You further understand and accept your financial responsibility for any portion of the bill not covered by your health insurer or health plan. SUBMISSION OF CHARGES DOES NOT WAIVE OUR RIGHT TO SEEK PAYMENT DIRECTLY FROM YOU.