Article 1: Agreement to Arbitrate: The patient and SOFLO MEDICAL CENTER, the undersigned Medical Care Provider (“MCP”) - which includes any affiliated physicians, employees, any related medical group, professional association, or any other entity or individual which has provided medical services in conjunction with the MCP – agree to submit any dispute whatsoever to binding arbitration including without limitation any claim for malpractice, personal injury, battery, breach of express or implied contract, loss of consortium, wrongful death or any payment or any other disputes relating in any way to past, present or future medical care. Any dispute will go to binding arbitration.
Article 2: All Claims Must be Arbitrated: The patient, and/or his or her spouse, born or unborn children, parents, heirs, or anyone launching any legal or equitable action (hereinafter “the Patient”) and the MCP agree that any complaint of any type which in any way relates to medical services shall, without exception, be submitted to binding arbitration. The governing law shall be the Federal Arbitration Act, state law notwithstanding. It is the express intention of the parties that any and all claims or complaints of any kind shall be submitted to and resolved by binding arbitration, which will be the exclusive and sole remedy. It is the specific and irrevocable intention of the parties to submit any question concerning this Agreement’s arbitrability to the arbitrators only and to no other person or entity. For all issues regarding the validity of this Agreement in court, the prevailing party shall be entitled to attorney’s fees and to costs as determined by the court.
The MCP and any affiliated medical service provider that chooses to join in this Agreement agree to be equally bound just as the Patient is bound to binding arbitration in the event of any dispute. Such disputes can be brought by the MCP against the Patient, including terms of payment, services rendered, physical or emotional abuse, and other disputes. The Patient understands that any and all medical care provided is sufficient consideration, and the Patient will be fully and legally bound by this Agreement. Both parties to this Agreement are giving up their constitutional right to have any dispute decided in a court of law before a jury. All parties understand that they are giving up their right to have any dispute decided by a judge or jury through the court system. Resorting to the legal system by action at law or in equity will only be permissible if necessary to enforce any decisions reached through arbitration. The parties agree that any dispute about any provisions of this Agreement will be decided through arbitration.
The parties hereby bind anyone whose claims may arise out of or relate to treatment or services provided by the MCP at the time of the occurrence giving rise to the claim. In the case of any pregnant mother, the term “patient” means both the mother and the mother’s expected child or children. The parties consent to the participation in this arbitration of any person or entity that would otherwise be a proper additional party in a court action if they have been involved in any way in the care of the Patient. This may include claims of the Patient against other physicians, nurses or medical professionals, or a hospital or other facility. Additionally, this Agreement is intended to resolve all claims for vicarious liability of the MCP.
Article 3: Recovery: The signers agree that the maximum total amount of all noneconomic and economic damages combined shall never exceed $250,000.00, applied on a per case basis, regardless of the number of claimants seeking compensation, and regardless of the number of physicians, professional associations, employees or entities named as defendants. The Patient agrees to waive any and all rights to any higher award. This limitation applies regardless of whether another healthcare provider, such as a physician, a hospital or other facility or employees of such a physician, hospital or facility are named as defendants in the binding arbitration or in any other proceedings. “Noneconomic damages” means nonfinancial losses that would not have occurred but for the injury giving rise to the cause of action, including pain and suffering, inconvenience, physical impairment, mental anguish, disfigurement, loss of capacity for enjoyment of life, and other nonfinancial losses to the extent the claimant is entitled to recover such damages under general law, including the Wrongful Death Act. The arbitrators may choose to award damages in excess of $250,000.00 only when extreme hardship is demonstrated. As consideration for the limitation on any waivers, the MCP will pay up to and only the first $2,500.00 of attorney fees for the Patient.
The parties agree that if any punitive damages are awarded, they may not exceed three times any compensatory award. Same as required by Medicare/Medicaid, the parties agree that any awards in excess of $10,000.00 shall be paid in equal annual payments over ten (10) years without being reduced to present value. The arbitrators may reduce the time period in cases of extreme hardship. They will also consider any other collateral sources of compensation (e.g., workers compensation, life insurance, disability, charitable, and governmental benefits, and other monies paid to the injured patient or any other party) which shall diminish any awards for noneconomic and/or economic damages. The MCP shall be entitled to an off-set for any monies received by the Patient for claims against any other health care provider, if such claims arise out of or relate in any way to the claims of the Patient against the MCP. The parties agree to the complete disclosure of all collateral sources of compensation. Failure to promptly disclose any additional sources on request is agreed to be grounds for immediate and total dismissal of any claim.
Article 4: Statute of Limitations: In no case shall the statute of limitations exceed twelve (12) months from the date any alleged injury or problem could or should have been discovered regardless of the age of the Patient. The arbitrators and their empowerment under the FAA shall determine any question concerning the application of this provision. If this provision is held to be invalid it is replaced by the statute of limitations set forth in F.S. §766.
Article 5: Severability: If any specific term or provision of this Agreement is determined by a court of competent jurisdiction to be illegal, invalid, or otherwise unenforceable, the entire remainder of this Agreement shall be construed to be in full force and effect, and all other provisions will still apply. The Parties agree in general that any provisions so challenged will be brought to the arbitrators to decide upon, and not to a judge or jury.
Article 6: Merger Clause: This Agreement represents the entire agreement made between the MCP and the Patient. It supersedes any other agreements between the Patient and the MCP. Except as expressly set forth herein, there are no other representations, promises, understandings, or agreements of any kind between the parties. The Patient signing this Agreement acknowledges that he or she has not relied in any way upon any oral or written statements made to them besides what is contained within this Agreement. All parties acknowledge and understand that this Agreement cannot be changed, altered or modified in any way except by an instrument in writing, signed by all parties.
Article 7: Pronouns and Headings: The singular shall be held to include the plural, the plural held to include the singular, and the use of any gender shall be held to include every gender. All headings, titles, subtitles, or captions are inserted for convenience only, and are to be ignored in any construction of the provisions hereof.
Article 8: Procedures and Applicable Law: The parties agree to try to resolve all issues within nine (9) months of any complaint. This Agreement, its substantive provisions, the scope of the Agreement, the authority granted to the arbitrators and the limitations contained in this Agreement, are to be governed by, and interpreted pursuant to the Federal Arbitration Act, any conflicting state law notwithstanding. To the extent not inconsistent with the FAA, it shall also be governed by the provisions of the Revised Uniform Arbitration Act as adopted in the principal state where the MCP practices. The parties agree that any dispute between them shall be determined by a panel of three arbitrators. Each party shall select one arbitrator from a list of qualified legal/medical experts provided by the MCP. All arbitrators will hold either Medical Degrees or both Medical and Juris Doctor Degrees. The two arbitrators selected shall then select a third arbitrator from the same list. Each party may remove the other’s chosen arbitrator only once. The three arbitrators shall resolve any and all disputes between the parties pursuant to the National Arbitration Forum Code of Procedure or such procedures as they may jointly decide.
All arbitration hearings shall be conducted by video conference; the MCP will provide equipment and pay all costs of video conference bridging and that of the arbitrators. The parties shall adopt rules of evidence such as the arbitrators may see fit. The MCP shall pay the full costs of the arbitration, but shall not be responsible for paying any fees or costs charged to the Patient by their attorney save the first $2,500.00 as indicated above. Reasonable discovery will be permitted by both sides. The parties agree that the arbitrators are to render a written decision with reasons stated for the decision. This agreement is to be construed to follow F.S. §766 and provides patient with all rights necessary under F.S. §766 and the Florida Medical Malpractice Act. With the exceptions of a right to a trial by jury and the statute of limitations, if there is a conflict between this Agreement and either F.S. §766 or the Florida Medical Malpractice Act then F.S. §766 or the Florida Medical Malpractice Act will prevail.
Article 9: Right of Counsel and Rescission: The Patient understands that this Agreement is a legal document, and the Patient has the right to consult with an attorney before signing if desired. Your MCP encourages you to consult an attorney prior to signing or during a fifteen (15) day rescission period. You may rescind this Agreement for fifteen (15) days after signing it; you agree that it will be in full force and effect until the date received at the MCP’s office. To rescind it, return a copy to the MCP by certified mail-return receipt only with “CANCELED” written on the first page, and signed by you underneath that word. The Agreement will then be rescinded for all future care, but you agree it will be valid for any and all care provided by the MCP to the Patient for the entire period of all medical services up to the rescission.
Article 10: Authority to Sign: The Patient represents that he or she does have the authority to sign and execute this document on his/her own behalf (if signed by the Patient), or on behalf of the Patient (if signed by a person other than the Patient.)
Article 11: No Undue Influence: The individual signing this Agreement hereby acknowledges that he or she has not been pressured, induced, coerced, or intimidated in any way into signing this agreement, and has signed it of his or her own free will and accord and not under duress of any kind. The parties agree that they have been given every opportunity to ask questions and received answers concerning the specifics and intent of their Agreement.
Article 12: Frivolous Legal Actions: The Patient agrees that under no circumstances will a frivolous action or claim be brought against the MCP, and the MCP agrees to not bring any frivolous action or claim against the Patient. If two or more Arbitrators rule that any action or claim brought against either party if frivolous in nature, the prevailing party shall be entitled to economic and noneconomic damages, including loss of wages or other compensation, damage to reputation, full attorney’s fees and punitive damages.
Article 13: Mediation: At the MCP’s sole expense, upon any compliant or alleged injury, the parties agree to promptly mediate in good faith with a qualified mediator prior to any arbitration hearing. A qualified professional mediator with medico-legal background shall be mutually agreed upon.
NOTICE: BY SIGNING THIS CONTRACT, YOU AGREE TO HAVE ANY ISSUE OF ALLEGED MEDICAL NEGLIGENCE OR BREACH OF CONTRACT BETWEEN YOU AND YOUR MCP DECIDED BY BINDING ARBITRATION IN WHICH BOTH PARTIES GIVE UP THEIR RIGHT TO A TRIAL BY JURY OR TRIAL BY A JUDGE.
I hereby agree that all provisions of this Agreement are in full effect, and no word, sentence paragraph or provision may be crossed out, excised or removed.
By purchasing any item or services you are agreeing to the above
ARBITRATION AGREEMENT
Consent to Telehealth
Telehealth allows for the remote delivery of healthcare services via electronic communication, connecting patients with providers. While Telehealth offers many potential benefits, it also carries certain risks. These include, but are not limited to, limitations in the ability to fully assess some conditions that may require in-person care. Telehealth is not a complete substitute for in-person medical care in all cases. If you are uncomfortable with the risks associated with Telehealth, you should seek in-person treatment. By using our services, you agree to and acknowledge that SoFlo Medical Center is a third-party beneficiary of the Medical Consent and has the right to enforce its terms.
Use by Minors
The service is not intended for use by anyone under the age of eighteen (18). Minors under the age of eighteen are prohibited from using any part of the Service and/or Platform, except to read these Terms and Conditions.
Your Relationship with SoFlo Medical Center INC
As part of the Service, we make available certain products and services sold and/or offered by us, third-party providers (medical and/or nursing care), pharmacies, diagnostic laboratories, and other vendors. Our providers offer certain independent medical and/or nursing services. By accepting these Terms and Conditions, you acknowledge and agree that any services or products received from the aforementioned individuals and/or groups are also bound by this Agreement, and that they are third-party beneficiaries of this Agreement.
Independent Medical Care
SoFlo Medical Center INC. has no control over or involvement with the practice of medicine, nursing, or any other form of care by providers. All providers are individually and solely responsible for managing the medical care and/or treatments they provide to you. By accepting this Agreement, you understand and agree that SoFlo Medical Center INC. is not acting as a healthcare provider, and that you are not entering into a patient-provider relationship with us. However, by accepting this Agreement, you understand and agree that you may be entering into a patient-provider relationship with any one or more Providers.
Independent Pharmacy Services
By accepting this Agreement, you understand and agree that SoFlo Medical Center INC. is not acting as a pharmacy, nor do we control or interfere with any such services. By accepting this Agreement, you understand and agree that you may be entering into a relationship with a pharmacy, pharmacist, and/or pharmacy group. You authorize these entities to access your prescription records through a Controlled Substances Prescription Management Program (CSPMP) or any other legally required program. SoFlo Medical Center INC. employs licensed providers in Florida who have “Dispensing Practitioner” as part of their Florida license, allowing them to dispense medications to their patients in the state.
Consent to Communication
By accepting this Agreement, you agree that SoFlo Medical Center INC., along with third-party providers and pharmacies, may communicate with you regarding your treatment via email, text messages (SMS/MMS), phone calls, and voicemails (collectively, “Communications”). You acknowledge and accept that SoFlo Medical Center INC. and its affiliates are not responsible for the contents or security of these communications. These messages may contain important information about your health and treatment, and it is your responsibility to receive and read them. You also agree to hold SoFlo Medical Center INC., its employees, officers, and affiliates harmless for any issues related to the receipt or reading of these communications. Additionally, you accept that some communications may be marketing or advertising in nature.
Financial Responsibility for Services
SoFlo Medical Center INC. and/or its subsidiaries are not enrolled in or accepting any state, local, or federal healthcare programs, such as Medicare or Medicaid. By engaging with SoFlo Medical Center INC. and using the Services, you are choosing to obtain service solely on a cash-basis and are financially responsible for all associated costs. By accepting this Agreement, you agree not to submit any claims for reimbursement to any state, local, or federal healthcare programs. SoFlo Medical Center INC. can provide superbills upon request, but no other medically coded invoices for services. Regular invoices will be provided upon request.
Prescription Requirements
Some of the products and services offered via the platform require a valid prescription. Payment does not guarantee the writing or dispensing of any prescription medication. You will not receive a prescription unless you have completed a medical intake form, established a patient-provider relationship with a provider, completed a medical consultation, and the provider has determined a medical need for the prescription. If you choose to use an affiliated pharmacy to fulfill the prescription, the charges will be bundled into the overall cost.
Dispute Resolution and Arbitration
If a dispute arises related to this contract that cannot be resolved through direct discussions, the parties agree to attempt mediation administered by the American Arbitration Association (AAA) under its Healthcare Payor Provider Mediation Procedures. If mediation is unsuccessful, the dispute will be settled by binding arbitration administered by the AAA under its Healthcare Payor Provider Arbitration Rules. The award rendered by the arbitrator(s) may be entered into any court with jurisdiction.
Class Action Waiver
You waive the right to participate in any class action, private attorney general action, or other representative action in court or group arbitration, either as a class representative or class member. You also waive the right to join or consolidate claims with any other person or group, as allowed by law.
Severability Clause
If any provision of this Agreement is deemed illegal, unenforceable, or invalid in any jurisdiction, it will not affect the enforceability or validity of any other provision in that jurisdiction, nor will it affect the enforceability or validity of that provision in other jurisdictions.
Assignment of Agreement
This Agreement is solely between you and SoFlo Medical Center INC. Your rights under this Agreement may not be assigned to anyone else. Any attempt to do so is null and void. SoFlo Medical Center INC. reserves the right to assign or transfer any part of this Agreement, at any time and at its sole discretion, without your additional consent or notice.
By purchasing vitamin injections through SOFLO MEDICAL CENTER and completing the telehealth visit provided by us, you consent to receiving these injections, which may include but are not limited to Vitamin B12, Vitamin D, Vitamin C, Biotin, NAD+, Glutathione, Lysine, and other essential vitamins and nutrients.
Purpose and Benefits:
Vitamin injections aim to support overall health and wellness by addressing nutritional deficiencies and enhancing energy, immunity, and other bodily functions.
Potential Benefits:
- Increased energy and reduced fatigue
- Improved immune function
- Enhanced skin, hair, and nail health
- Overall nutritional support
Possible Risks and Side Effects:
Potential risks may include, but are not limited to:
- Pain, redness, or swelling at the injection site
- Allergic reactions (rash, itching, difficulty breathing)
- Nausea, diarrhea, or upset stomach
- Dizziness or lightheadedness
- Infection at the injection site (rare)
- Interactions with current medications or medical conditions
Contraindications:
Vitamin injections may not be suitable for individuals with the following conditions:
- Allergies to any of the ingredients in the injection
- Pre-existing medical conditions such as kidney disease, heart problems, or metabolic disorders
- Pregnant or breastfeeding women (unless cleared by a healthcare provider)
- Individuals on certain medications that may interact with the vitamin injections
By purchasing these injections and completing the telehealth visit, you confirm that you have provided accurate medical information, including allergies, medications, and health conditions, and you are not aware of any reason why receiving these injections would be unsafe.
Alternatives:
You understand that alternatives to vitamin injections are available, including oral supplements and dietary changes. You may pursue these alternatives at your discretion.
Consent for Procedure:
By making this purchase and completing the telehealth visit, you acknowledge and agree that:
- You understand the purpose, benefits, and risks of vitamin injections.
- You have had the opportunity to seek medical advice regarding these injections during the telehealth visit or with another healthcare provider, if necessary.
- You voluntarily consent to receiving vitamin injections purchased online from [Company/Clinic Name].
- You accept responsibility for any potential risks associated with the injections.
You release SOFLO MEDICAL CENTER] and their staff from any liability related to the administration of these injections, except in cases of negligence.
If you experience any adverse reactions or have concerns following the injection, please contact your healthcare provider immediately.
Thank you for your cooperation.
Procedure:
By purchasing semaglutide or tirzepatide injections from Soflo Medical Center and completing the telehealth visit provided by us, you consent to receiving these medications for the management of weight loss and/or type 2 diabetes, depending on your treatment plan.
Medications:
- Semaglutide: A glucagon-like peptide-1 (GLP-1) receptor agonist used to aid in weight loss and manage blood sugar in patients with type 2 diabetes.
- Tirzepatide: A dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptor agonist used to treat type 2 diabetes and for weight loss in certain cases.
Purpose and Benefits:
The primary goals of these medications include:
- Supporting weight loss by helping to control appetite
- Improving blood sugar levels in patients with type 2 diabetes
- Reducing the risk of cardiovascular events in some individuals with diabetes
Potential Benefits:
- Significant reduction in body weight
- Better blood sugar control
- Improved energy levels and overall health outcomes
Possible Risks and Side Effects:
While semaglutide and tirzepatide are generally considered safe when administered properly, potential risks include, but are not limited to:
- Nausea, vomiting, diarrhea, or constipation
- Decreased appetite or digestive discomfort
- Low blood sugar (hypoglycemia), especially if taken with insulin or sulfonylureas
- Injection site reactions (redness, pain, or swelling)
- Possible allergic reactions (rash, itching, or difficulty breathing)
- Pancreatitis (inflammation of the pancreas)
- Gallbladder issues, such as gallstones
Contraindications:
These injections may not be suitable for individuals with the following conditions:
- A personal or family history of medullary thyroid carcinoma (MTC) or Multiple Endocrine Neoplasia syndrome type 2 (MEN 2)
- History of pancreatitis
- Severe kidney or liver disease
- Allergies to any of the components of semaglutide or tirzepatide
- Pregnant or breastfeeding women (unless approved by a healthcare provider)
By purchasing these injections and completing the telehealth visit, you confirm that you have disclosed all relevant medical history, including any allergies, medications, or underlying health conditions, and are not aware of any contraindications that would make these medications unsafe for you.
Alternatives:
You understand that alternatives to semaglutide and tirzepatide for weight loss management may include oral, injections medications, lifestyle changes (diet and exercise), and other forms of therapy. You have been given the opportunity to explore these alternatives.
Consent for Procedure:
By purchasing semaglutide or tirzepatide injections from Soflo Medical Center and completing the telehealth visit, you acknowledge and agree that:
- You have had the purpose, benefits, and risks of these medications explained to you during the telehealth visit or by another healthcare provider.
- You understand the potential side effects and have had the opportunity to ask questions.
- You voluntarily consent to receiving semaglutide or tirzepatide injections from Soflo Medical Center.
- You accept responsibility for any potential risks or side effects related to these medications.
You release Soflo Medical Center and its staff from any liability related to the administration of these injections, except in cases of negligence.
If you experience any adverse reactions or have concerns following the injection, please contact your healthcare provider or Soflo Medical Center immediately.
Thank you for your cooperation.