SteadiCare Telehealth Consent

STEADICARE TELEHEALTH CONSENT

Effective Date: September 1, 2026

Notice Regarding OpenLoop-Facilitated Services: If you are receiving healthcare services facilitated through OpenLoop Health, Inc. ("OpenLoop"), you will also be asked to review and sign OpenLoop's Telehealth Consent Form. Both this SteadiCare Telehealth Consent and the OpenLoop Telehealth Consent Form govern your care. Where the two documents overlap, both apply; in the event of a conflict regarding OpenLoop's obligations, the OpenLoop Telehealth Consent Form controls with respect to OpenLoop's services.

EMERGENCY NOTICE: TELEHEALTH IS NOT AN EMERGENCY SERVICE. IF YOU ARE EXPERIENCING A MEDICAL EMERGENCY, CALL 911 OR GO TO YOUR NEAREST EMERGENCY ROOM IMMEDIATELY. DO NOT USE THIS PLATFORM TO SEEK EMERGENCY CARE. STEADICARE AND ITS AFFILIATED PROVIDERS CANNOT GUARANTEE RESPONSE TIMES AND ARE NOT EQUIPPED TO HANDLE LIFE-THREATENING SITUATIONS.

I. Parties

This Telehealth Consent ("Consent") is entered into between you ("Patient," "you," or "your") and the following entities:

SteadiCare LLC ("SteadiCare") is a management services organization ("MSO") that provides administrative, technology, and operational support services to licensed professional healthcare entities. SteadiCare is not a licensed healthcare provider and does not practice medicine.

ADPS Network, PLLC ("ADPS") is a licensed professional limited liability company organized under Texas law that employs or contracts with licensed physicians, nurse practitioners, and other licensed professionals to provide telehealth services to patients in the State of Texas.

OpenLoop Health, Inc. ("OpenLoop") is a healthcare services platform that, for patients in states not covered by ADPS providers, connects patients with independently contracted licensed healthcare providers. OpenLoop operates under separate terms, and OpenLoop-facilitated providers are independent contractors, not employees or agents of SteadiCare or ADPS.

Each patient is served exclusively by one of these provider networks — either ADPS or OpenLoop — determined at enrollment based on the patient's state of residence and provider availability. A patient served by ADPS providers has no treatment relationship with OpenLoop, and vice versa. Collectively, the licensed providers delivering your care through whichever network applies to you are referred to in this Consent as "Providers."

II. What Is Telehealth

Telehealth refers to the delivery of healthcare services using electronic communications, information technology, or other means between a licensed healthcare provider and a patient who are not in the same physical location. Telehealth services may include but are not limited to:

• Clinical evaluations, assessments, and consultations conducted via video, audio, or asynchronous messaging
• Diagnosis and treatment planning
• Prescription and medication management
• Patient education and counseling
• Follow-up and ongoing care coordination

The telehealth services provided through SteadiCare's platform are conducted using HIPAA-compliant technology platforms. Your Provider will use professional judgment to determine whether telehealth is appropriate for your condition and may refer you to in-person care when clinically indicated.

III. Benefits and Risks of Telehealth

A. Benefits.

Telehealth services may provide the following benefits:

• Improved access to healthcare from the convenience of your home or another location of your choice
• Reduced travel time and associated costs
• Increased flexibility in scheduling
• Continuity of care between in-person visits
• Access to specialists and providers who may not be locally available

B. Risks and Limitations.

As with any medical service, telehealth carries certain limitations and risks, including:

• Telehealth may not be appropriate for all medical conditions. Your Provider will determine whether your condition can be adequately assessed and treated through telehealth.
• The absence of a physical examination may limit your Provider's ability to diagnose certain conditions or detect findings that would be apparent during an in-person visit.
• Technology failures, including poor internet connectivity, hardware malfunctions, or software errors, may interrupt or degrade your telehealth session. In the event of a technical failure, your Provider will attempt to contact you by telephone using the number on file.
• Electronic transmission of your health information carries inherent security risks. We use HIPAA-compliant encryption and security protocols, but no technology is completely secure.
• SteadiCare's services are cash-pay and are not billed to health insurance plans. You are responsible for the full cost of services, regardless of any coverage you may carry.
• State laws governing telehealth vary, and your Provider may be subject to limitations based on where you and your Provider are located.

IV. Your Consent to Telehealth Services

By signing this Consent, you acknowledge and agree to the following:

• You consent to receive healthcare services through telehealth from Providers affiliated with ADPS or facilitated through OpenLoop.
• You understand the benefits, risks, and limitations of telehealth as described in this Consent.
• You have had the opportunity to ask questions about telehealth services and your questions have been answered to your satisfaction, or you waive the opportunity to ask questions.
• You understand that you may withdraw this Consent at any time by providing written notice to SteadiCare at support@steadicarehealth.com, and that withdrawal of Consent will not affect care already provided.
• You understand that your Provider retains the right to discontinue telehealth services and refer you to in-person care if, in their professional judgment, telehealth is not appropriate for your condition.
• You understand that SteadiCare and your Provider each reserve the right to terminate the provider-patient relationship at any time for clinical, professional, or administrative reasons, with reasonable notice and assistance in transitioning your care to another provider where feasible.
• You understand that SteadiCare does not guarantee access to any specific Provider. Providers may change based on availability, licensure, and clinical appropriateness.
• You confirm that you are located within the United States at the time of each telehealth encounter and that you are physically present in the state you have indicated during registration.
• You are at least 18 years of age.

V. Artificial Intelligence, Automated Technologies, and Data Processing

A. Ambient Listening and AI-Assisted Documentation.

SteadiCare's platform and/or your Provider may use artificial intelligence tools, including ambient listening technologies, to assist with clinical documentation, session transcription, and medical record creation. By participating in telehealth services through this platform, you consent to:

• The use of ambient listening or audio/video capture technologies during your telehealth visits for the purpose of generating clinical notes and documentation
• AI-assisted analysis of session content to support clinical documentation and care coordination
• Storage and processing of your session data by HIPAA-compliant AI vendors engaged by SteadiCare or your Provider

You may opt out of ambient listening by notifying your Provider at the beginning of your session. Opting out will not affect your access to care, though your Provider may document the session manually.

B. AI-Assisted Intake and Clinical Support.

SteadiCare may use AI-assisted tools to help process intake questionnaires, identify care pathways, and support clinical decision-making. These tools are used to assist Providers and do not replace clinical judgment. All treatment decisions are made by your licensed Provider.

C. Recording.

Telehealth sessions may be recorded for quality assurance, training, or clinical documentation purposes. You will be notified at the beginning of any session that is being recorded. If you do not consent to recording, you may inform your Provider prior to or at the start of the session. Recording without your consent is prohibited, except as otherwise required by law.

VI. Privacy and Health Information

Your Protected Health Information ("PHI") is governed by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and applicable state privacy laws. By participating in telehealth services:

• You acknowledge SteadiCare's Privacy Policy, available at steadicarehealth.com/privacy-policy, which describes how SteadiCare collects and uses information through its platform.
• If you are served by ADPS Network, PLLC providers: You acknowledge receipt of ADPS Network, PLLC's Notice of Privacy Practices, which describes how your PHI may be used and disclosed by ADPS and is available at steadicarehealth.com/adps-notice-of-privacy-practices. OpenLoop's Notice of Privacy Practices does not apply to your care.
• If you are served through OpenLoop: You acknowledge that OpenLoop's Notice of Privacy Practices, available at openloophealth.com/notice-of-privacy-practices, governs how your PHI is used and disclosed in connection with your care. ADPS's Notice of Privacy Practices does not apply to your care.
• You consent to the use and disclosure of your PHI for treatment, payment, and healthcare operations as described in the Notice of Privacy Practices applicable to your provider network.
• You consent to the transmission of your health information via electronic communications using HIPAA-compliant technology. You understand that electronic communications carry inherent security risks despite reasonable precautions.

VII. Financial Consent and Payment Authorization

A. Fees and Payment.

SteadiCare's services are offered on a subscription or fee-for-service basis as described at the time of enrollment. By enrolling, you authorize SteadiCare to charge the payment method on file for all applicable subscription fees, visit fees, and other charges in accordance with the fee schedule disclosed at enrollment.

B. Automatic Renewal and Recurring Charges.

Subscription plans automatically renew unless you cancel in accordance with SteadiCare's Cancellation and Refund Policy, available at steadicarehealth.com/cancellation-policy. By providing a payment method, you authorize SteadiCare to charge recurring fees at the applicable renewal rate.

C. Non-Covered Services.

SteadiCare does not bill insurance for its services. You are responsible for the full cost of all services at the time they are provided, regardless of whether you have health insurance coverage. SteadiCare's services may not be covered by Medicare, Medicaid, or private insurance plans. You are solely responsible for determining your insurance coverage and understanding any applicable benefits or exclusions.

D. Failed Payments.

If a payment is declined or fails, SteadiCare may suspend your access to services until payment is resolved. SteadiCare reserves the right to pursue collection of outstanding balances and may report delinquent accounts to credit agencies in accordance with applicable law.

VIII. Prescription and Shipping Authorization

A. Prescription Services.

If your Provider determines that prescription medication is appropriate for your care, prescriptions will be routed electronically to SteadiCare's partner pharmacies, which are licensed and may include compounding pharmacies. Partner pharmacies are selected for their ability to fulfill the compounded formulations prescribed through SteadiCare's clinical protocols.

B. Shipping Authorization.

If you elect to have medications shipped to you directly, by signing this Consent you authorize SteadiCare and its partner pharmacies to:

• Ship prescription medications to the address you provide
• Collect and store your shipping address for purposes of prescription fulfillment
• Obtain signature on delivery if required by the pharmacy or applicable law

You are responsible for ensuring that someone is available to receive temperature-sensitive medications and that your shipping address is accurate and current. SteadiCare is not responsible for medications lost, stolen, or damaged in transit once delivered to the shipping carrier.

IX. Compounded Medications

A. Nature of Compounded Medications.

Some medications prescribed through SteadiCare's platform may be prepared by licensed compounding pharmacies ("compounded medications"). Compounded medications are:

•Custom-prepared formulations made specifically for individual patients based on a valid prescription from a licensed provider

•Not FDA-approved drug products, meaning they have not undergone the FDA's drug approval process for safety, efficacy, and manufacturing quality

•Prepared in accordance with applicable federal law (21 U.S.C. § 503A or § 503B, as applicable) and state pharmacy regulations

B. Risks of Compounded Medications.

By consenting to the use of compounded medications, you acknowledge and accept the following:

• Because compounded medications are not FDA-approved, the FDA has not verified their safety, effectiveness, or quality through its standard review process
• Compounded medications may have different potency, stability, or bioavailability compared to commercially manufactured drugs
• The appearance, taste, or form of compounded medications may differ from commercially available versions of the same drug
• Insurance plans typically do not cover compounded medications, and you will be responsible for the full cost
• Your compounded prescription is prepared specifically for you and may not be transferred to or used by another person

C. Your Consent.

By signing this Consent, you authorize your Provider to prescribe compounded medications as clinically appropriate, you consent to the dispensing of compounded medications by SteadiCare's partner pharmacies, and you acknowledge that you have been informed of the nature and risks of compounded medications.

X. Texas-Specific Disclosures

The following disclosures apply to patients located in the State of Texas and receiving care from ADPS Network, PLLC providers:

A. Texas Medical Board.

ADPS Network, PLLC and its providers are subject to regulation by the Texas Medical Board. Patients who have complaints regarding the care they receive may contact:

Texas Medical Board

333 Guadalupe, Tower 3, Suite 610

Austin, TX 78701

(512) 305-7030

www.tmb.state.tx.us

B. Texas Telemedicine Rules.

Under Texas law, a physician or other healthcare provider may establish a provider-patient relationship through telehealth and may prescribe medications through telehealth, provided the provider conducts an appropriate evaluation and meets applicable standard-of-care requirements. Providers at ADPS comply with Texas Medical Board rules governing telemedicine and prescribing.

C. Texas Identity Verification.

In accordance with Texas Medical Board rules, your Provider may require identity verification at the start of your telehealth encounter. You agree to provide accurate identification information and to cooperate with any verification process required by your Provider.

D. Texas Prescription Rules.

Texas law permits prescribing via telehealth when a proper provider-patient relationship has been established. Controlled substances may be subject to additional requirements under Texas and federal law, and not all controlled substances may be prescribed through telehealth.

XI. Multi-State Services via OpenLoop

At enrollment, SteadiCare determines which provider network will serve you based on your state of residence and the licensure and availability of providers at the time of enrollment. Patients located in Texas are typically served by ADPS Network, PLLC providers; patients in other states are served by providers facilitated through OpenLoop. In some cases — including based on provider availability or other factors assessed at enrollment — a patient may be routed through OpenLoop regardless of state of residence. You will be informed of which network is serving you during the enrollment and intake process. If you relocate to a different state after enrollment, please notify us at support@steadicarehealth.com so we can confirm continued coverage.

For patients served through OpenLoop:

• Your treating Provider is an independently contracted licensed clinician facilitated through OpenLoop's platform, and not an employee of SteadiCare or ADPS
• OpenLoop's Telehealth Consent Form (openloophealth.com/telehealth-consent) and Notice of Privacy Practices (openloophealth.com/notice-of-privacy-practices) also apply to your care
• The applicable state telehealth laws of the state where you are located at the time of your visit govern your encounter
• Your Provider will be licensed in the state where you are located and will comply with that state's applicable regulations

XII. SteadiCare as Third-Party Beneficiary

You acknowledge that SteadiCare is an intended third-party beneficiary of all consents, authorizations, and agreements you enter into with ADPS and OpenLoop-facilitated Providers in connection with services coordinated through SteadiCare's platform. SteadiCare is entitled to enforce this Consent and any related agreements to the extent necessary to protect its legitimate interests as the coordinating MSO.

XIII. Withdrawal of Consent

You may withdraw this Consent at any time by providing written notice to SteadiCare at support@steadicarehealth.com. Withdrawal of Consent will not affect the lawfulness of any services already rendered or any charges already incurred. Upon withdrawal, SteadiCare will terminate your access to telehealth services and may recommend alternative providers for your continued care, at its discretion.

XIV. Limitation of Liability

To the maximum extent permitted by applicable law, SteadiCare's liability in connection with telehealth services is limited as set forth in the SteadiCare Terms of Service, available at steadicarehealth.com/terms-of-service. Nothing in this Consent limits the professional liability of your treating Provider, who remains individually responsible for the standard of care delivered during your telehealth encounters.

XV. Acknowledgment and Electronic Signature

By electronically signing this Consent, you acknowledge that:

• You have read this Consent in its entirety and understand its terms
• You have had the opportunity to ask questions and receive answers before signing
• You voluntarily consent to receive telehealth services under the terms described herein
• Your electronic signature is legally binding and has the same force and effect as a handwritten signature under the Electronic Signatures in Global and National Commerce Act (E-SIGN) and applicable state electronic signature laws
• You are at least 18 years of age

This Consent is effective as of the date of your electronic signature and remains in effect for all subsequent telehealth services received through SteadiCare's platform, unless withdrawn as provided in Section XIII.

Questions and Contact Information

For questions about this Consent or your telehealth services, please contact:

SteadiCare LLC

support@steadicarehealth.com

steadicarehealth.com