Important Medical & Legal Notice

Clinical services are provided by a licensed Physician Assistant practicing in accordance with Indiana law, including statutes governing physician assistant practice, telemedicine services, and collaborative practice requirements.

Services are delivered within legally authorized scope and consistent with applicable standards of care. Nothing on this website represents independent practice of medicine beyond what is permitted under Indiana law.

Clinical decisions are based on professional judgment, available clinical information, and individualized patient evaluation. Medical recommendations reflect clinical findings at the time of assessment and may change as additional information becomes available or clinical conditions evolve.

Self-ish Rx provides evaluation, education, and clinical guidance based on information available at the time of the encounter and does not replace ongoing comprehensive medical care or emergency services.

Self-ish Rx operates as a hybrid care model utilizing telemedicine and, when clinically appropriate, in-person evaluation. The treating clinician determines the appropriate modality of care based on clinical presentation, patient safety considerations, and applicable standards of practice. Patients acknowledge:

• Telemedicine may serve as an initial evaluation, triage step, or follow-up modality.
• Not all conditions can be safely evaluated or treated through telemedicine alone.
• The clinician may recommend in-person care, diagnostic testing, referral, or emergency
  evaluation when medically necessary.
• Recommendations regarding care setting are based on clinical judgment and patient safety
  rather than patient preference alone.

Declining recommended escalation of care may increase clinical risk and may limit the ability to safely continue treatment.

Telemedicine services are available only to patients physically located within the State of Indiana at the time of the appointment, consistent with licensure requirements.

Identity and location verification are required prior to the visit.

If a patient is located outside Indiana at the time of service, clinical care will not be provided.

Telemedicine services are provided in accordance with Indiana telehealth statutes (IC 25-1-9.5).

Telemedicine encounters are held to the same professional standard of care as in-person services; however, inherent limitations exist.

Patients acknowledge:

• A complete hands-on physical examination cannot be performed virtually.
• Diagnostic accuracy may be limited by technology, visual quality, or available clinical information.
• Clinical decisions rely on patient-provided history, observable findings, and professional judgment.
• Symptoms and clinical conditions may evolve after evaluation.
• Technical disruptions may occur.

The clinician retains full discretion to determine whether telemedicine provides sufficient information for safe clinical decision-making.

If telemedicine does not allow adequate clinical assessment, the visit may be modified, discontinued, or converted to in person or higher-acuity care.

Self-ish Rx does not provide emergency medical care.

Do not use telemedicine for:

• Chest pain
• Difficulty breathing
• Stroke-like symptoms
• Severe trauma
• Uncontrolled bleeding
• Severe allergic reactions
• Mental health crisis or suicidal ideation
• Any potentially life-threatening condition

Call 911 or seek immediate emergency medical care.

Under Indiana law, a provider-patient relationship may be established via telemedicine when appropriate clinical standards are met.
Accessing this website, reading content, submitting messages, or scheduling alone does not establish a provider-patient relationship.

A provider-patient relationship is established only after:

• Identity verification
• Confirmation of Indiana physical location
• Completion of required intake documentation
• Telemedicine consent
• A completed clinical encounter meeting applicable standards of care.

All prescribing decisions are made at the sole professional discretion of the treating clinician and in accordance with Indiana and federal law.

Prescription issuance is not guaranteed.

Requests for specific medications may be declined if not clinically appropriate or when additional evaluation is required.

Self-ish Rx does not prescribe or refill opioid pain medications via telemedicine.

Prescribing decisions may require:

• additional clinical information
• prior records
• in-person evaluation
• diagnostic testing
• referral to another provider.

Clinical judgment supersedes patient preference. Failure to receive a requested medication does not constitute incomplete service.

Controlled substance prescribing complies with applicable Indiana statutes and federal regulations, including use of the Indiana Scheduled Prescription Electronic Collection and Tracking (INSPECT) program when required.

Telemedicine prescribing practices may be modified to maintain regulatory compliance.

All services are provided consistently with applicable standards of care.

Patients acknowledge:

• Telemedicine does not eliminate clinical uncertainty.
• Diagnostic limitations inherent to virtual care may affect evaluation.
• Clinical recommendations are based on information available at the time of assessment.
• New, evolving, or worsening symptoms require reassessment and may necessitate escalation of care.

Medicine involves uncertainty.

No guarantees are made regarding:

• Diagnosis
• Treatment success
• Symptom resolution
• Clinical outcome
• Insurance reimbursement.

Patients agree to:

• Provide accurate and complete medical information.
• Disclose medications, supplements, and allergies.
• Follow recommendations or seek referral when advised.
• Seek emergency care when instructed.
• Participate from a safe and private environment.
• Maintain functional technology for telemedicine visits.

Self-ish Rx operates as a cash-pay practice.

Payment is required at booking.
Fees compensate for professional time, clinical evaluation, and reserved appointment availability.

Missed appointments, late cancellations, or patient-related technical failures may result in forfeiture of fees.

If telemedicine is determined to be clinically inappropriate after evaluation begins, professional services have still been rendered and fees may not be refundable.

Insurance is not billed directly. Documentation may be provided for possible reimbursement; reimbursement is not guaranteed.

Supplement recommendations are optional.

Self-ish Rx does not manufacture supplements and does not guarantee outcomes.

Statements regarding supplements have not been evaluated by the Food and Drug Administration unless explicitly indicated.

When clinically appropriate, patients may be referred to other licensed healthcare professionals or facilities.

Referral does not constitute transfer of liability for care provided by third parties.

Recommendations for higher levels of care are made to support safe treatment and do not constitute abandonment of care.

HIPAA-compliant systems are used to protect protected health information.

Participation in telemedicine acknowledges inherent electronic communication risks.

Self-ish Rx reserves the right to decline, limit, or terminate services when:

• Care exceeds telemedicine safety parameters
• Requests fall outside legal or ethical scope
• Regulatory limitations apply
• Patient conduct is inappropriate or unsafe
• Clinical rapport cannot be maintained.

Services, pricing, policies, and regulatory procedures may change without prior notice.

Participation in telemedicine constitutes acknowledgment that the patient has reviewed and understood these disclosures.