Telehealth Services Terms of Service & Patient Agreement

Telehealth lets you meet with your doctor or care team using secure video and audio technology — from home, work, or wherever you are. You get the same expert oncology and surgical care without needing to come into the office for every visit.

This Agreement is between you (the patient, or your authorized representative) and the START Center (South Texas Oncology and Hematology), a Texas-licensed oncology, radiology and surgical practice. It governs all telehealth visits you have with us.

Two types of telehealth visits

Available via telehealth

• New patient and follow-up consultations (oncology, radiology and surgical)
• Review of lab results, imaging, and pathology reports
• Medication management and chemotherapy monitoring
• Symptom check-ins and care plan reviews
• Post-operative follow-up visits
• Second-opinion consultations
• Palliative care and advance care planning conversations
• Patient and caregiver education
• Genetic counseling referrals and survivorship planning

Requires an in-person visit

• Physical exams that require hands-on assessment
• Surgical procedures or biopsies
• Chemotherapy or infusion administration
• Imaging, lab draws, or specimen collection
• Any situation where your provider determines in-person care is safer

Choosing telehealth is always your decision. You have the right to refuse or stop telehealth at any time — this will never affect your ability to receive in-person care from us.

What you should know before agreeing

• Your medical information will be transmitted electronically. While we use secure technology, no digital system is 100% risk-free.
• Video or audio quality issues can sometimes affect the visit. If that happens, we will reschedule or switch to in-person.
• Telehealth has limitations — your provider cannot perform a hands-on physical exam remotely.
• Your provider will document the visit in your medical record, just as with in-person visits.

Your rights

• You may ask questions about telehealth before, during, or after any visit.
• You may withdraw your consent at any time without penalty.
• You have the right to choose in-person care instead.
• You may request a copy of your visit documentation.

Who can use telehealth

• You must be at least 18 years old, or have a parent or legal guardian participating with you.
• You must be physically located in Texas (or a state where your provider is licensed) during the visit.
• You must have a working camera, microphone, and internet connection.

We use a HIPAA-compliant telehealth platform to conduct all virtual visits. You may need to download an app or access a secure link we provide. We will send you instructions before your appointment.

What you need

• A smartphone, tablet, or computer with a camera and microphone
• A stable internet connection (Wi-Fi preferred)
• A private, quiet space where your conversation cannot be overheard
• Any app or software we specify — instructions will be sent before your visit

If technology fails during your visit

• Your provider will attempt to reconnect with you.
• If reconnection isn’t possible, our team will contact you to reschedule or arrange an in-person visit.
• We are not responsible for outages or failures caused by your device, internet provider, or third-party software.

Protecting your health information is one of our most important responsibilities. We comply fully with HIPAA (the federal health privacy law) and Texas state privacy laws.

How we protect your information

• All video visits are conducted on encrypted, HIPAA-compliant platforms.
• Your health information is never sold to third parties or used for advertising.
• Any vendors we work with (such as the telehealth platform) are bound by signed HIPAA Business Associate Agreements.
• Your full Notice of Privacy Practices is available at [Practice Website] or on request.

How you can protect your privacy

• Join your visit from a private location — not a public place.
• Use a secure, private Wi-Fi connection (avoid public hotspots).

Telehealth visits are billed in the same way as in-person visits. Texas law requires most state-regulated health plans to cover telehealth at the same rate as in-person care — but coverage varies by plan.

What to expect with billing

• We will submit claims to your insurance on your behalf.
• You are responsible for any copayments, deductibles, or coinsurance your plan requires.
• Please verify your telehealth benefits with your insurer before your visit — we cannot guarantee coverage.
• Self-pay rates are available. Please contact our billing team for details.

Cancellations & no-shows

• Please cancel at least[24/48] hoursbefore your appointment.
• Late cancellations or missed appointments may result in a no-show fee per our office policy.

Telehealth appointments are available during regular business hours and must be scheduled in advance through our patient portal or by calling the office.

Messages & portal communication

• Messages sent through the patient portal will be reviewed within[2] business days.
• The portal is not for urgent questions. If you have an urgent concern, please call us directly.
• After-hours telehealth availability is at the practice’s discretion and is not guaranteed.

Your provider may prescribe medications during a telehealth visit when clinically appropriate. All prescriptions are sent electronically to your preferred pharmacy.

Important limits

• Controlled substancesgenerally cannot be prescribed via telehealth under federal law (DEA regulations). There are narrow exceptions — your provider will advise you.
• Your provider will use independent clinical judgment on all prescribing decisions.
• Please let your provider know about all medications, supplements, and allergies before your visit

All telehealth encounters are fully documented in your medical record — the same way as in-person visits. You have the right to access, review, and request copies of your records.

To request records, please submit a written request to our Health Information Management team. Contact information is provided in Section 11 below.

Governing law & jurisdiction

This Agreement is governed by the laws of the State of Texas. Any disputes will be handled in [County] County, Texas courts.

Changes to this agreement

We may update these terms from time to time. When we do, we will notify you through the patient portal or at your next visit. Continued use of telehealth after changes means you accept the updated terms.

Limitation of liability

We are not responsible for interruptions caused by technology failures outside our control. We provide telehealth services in good faith and to the best of our clinical ability, but we cannot guarantee specific outcomes. Nothing in this Agreement limits our responsibility in cases of proven negligence.

If any part of this agreement is invalid

If a court finds any section of this Agreement unenforceable, that section will be adjusted to the minimum extent necessary and the rest of the Agreement remains in effect.

Questions about this Agreement or your telehealth visit? We’re here to help.

• Practice: The START Center for Cancer Care , 4383 Medical Dr, San Antonio, TX 78229
• Phone:(210) 593-5700
• Patient Portal: Navigating Care
• Privacy Officer: Travis Ryals / Privacy Officer / DPO@thestartcenter.com