Consent Policy

This Everlong Policies, HIPAA, Consent, & Release Agreement ("Agreement") for Everlong Inc., doing business as Everlong ("Everlong," "we," "us," or "our") describes our practice policies and the terms of your consent and release agreement when you use our telehealth nutrition counseling services ("Services"). By acknowledging or signing this Agreement during signup, you confirm that you have read, understood, and agreed to all terms contained herein.

PRACTICE POLICIES

Session Length

All sessions are 55 minutes long. To receive the full benefit of your session, please be present and ready at your scheduled start time. If you join late, the session will end at the originally scheduled time. If you leave early, your on-file payment method will be charged for the remaining session time.

No-Shows and Late Cancellations

We carefully schedule sessions to ensure that each patient receives personalized attention and care from their registered dietitian. As a courtesy, we provide multiple session reminders in advance of each scheduled session. If your plans change, we require at least 24 hours' notice to cancel or reschedule.

Failure to cancel or reschedule at least 24 hours before your scheduled session start time, or failure to attend your session, will result in a $150 no-show/late cancellation fee. This fee is not covered or reimbursable by insurance and will be charged directly to your credit or debit card on file.

By acknowledging this Agreement, you agree to maintain a valid credit or debit card on file, which may be charged for any no-show or late cancellation fee in accordance with this policy.

Telehealth Environment Requirements

To ensure the effectiveness and confidentiality of your telehealth session, you must be in a quiet, private, distraction-free environment for the duration of each session. You must not attend sessions while driving or engaged in any other activity that divides your attention.

If you are not in a suitable environment, or if your behavior during a session is disrespectful or inappropriate toward your registered dietitian, Everlong will not be able to conduct the session. In such cases, the session will be marked as a late cancellation and the applicable fee will apply.

Dietitian Accessibility Between Sessions

Our registered dietitians are available to you during your scheduled session times only. Outside of sessions, please use the patient portal for scheduling, cancellations, rescheduling, and other session-related requests. Everlong dietitians are not available for ongoing support, consultations, or clinical guidance via email, text message, or other informal channels between sessions.

Social Media and Professional Boundaries

To protect your confidentiality and maintain appropriate professional boundaries, Everlong does not accept friend or contact requests from current or former patients on social networking platforms. Connecting with patients on these platforms could compromise your privacy and blur the boundaries of the professional relationship. We are committed to preserving the integrity of your care.

Electronic Communication

Electronic communications — including email, text message, and internet-based messaging — cannot be guaranteed to be fully secure or confidential. Please do not use these methods to communicate session content, share sensitive health information, or request emergency assistance. In an emergency, call 911 immediately.

Telehealth is broadly defined as the use of information and communications technology to deliver health services and information across distances. For details on how telehealth sessions are conducted at Everlong, see the Consent for Telehealth section below.

Session Recording and AI-Assisted Notes

All sessions at Everlong are recorded and transcribed using secure technology to support accurate clinical documentation. These recordings are used to generate AI-assisted session notes, which become part of your medical record and help your dietitian deliver high-quality, personalized care. By acknowledging this Agreement, you expressly consent to the recording and transcription of your sessions for this purpose.

Recordings are stored securely for a limited period before being deleted. Transcripts and AI-generated summaries are retained as part of your clinical record in accordance with applicable law and Everlong's privacy and security policies.

Everlong may also use de-identified data derived from session transcripts or summaries to improve our tools, support clinical training and development, conduct research, and enhance care delivery. All such use is processed in compliance with HIPAA de-identification standards and does not include personally identifiable information unless we have received your explicit written authorization.

Multi-State Practice and Licensure

Everlong provides telehealth nutrition counseling services nationwide. Our registered dietitians are individually licensed in the states in which they practice. Applicable licensing requirements vary by state. By acknowledging this Agreement, you confirm that Everlong has informed you of the licensure status of your assigned dietitian as it relates to your state of residence. If Everlong is unable to match you with a qualified dietitian for your state, we will notify you promptly.

Young Adults Ages 18–26

If you are covered under a parent or guardian's health insurance plan, or if a parent or guardian is providing financial support for your services, by acknowledging this Agreement you consent to allow Everlong to discuss financial and insurance matters with that individual. This consent is limited to billing and insurance coverage purposes only and does not authorize the release of your clinical or health information without a separate written authorization.

Minors — Parental or Guardian Consent Required

Patients under the age of 18 cannot legally consent to their own treatment. A parent or legal guardian must provide consent on their behalf. For a minor's initial session, a parent or legal guardian must be present.

If a parent or guardian is unable to attend and sends another individual (such as a grandparent, sibling, or caregiver), that individual does not have legal authority to consent to treatment unless Everlong has received prior written authorization specifying that individual by name. If a minor attends a session without a parent or guardian present and no such authorization is on file, the session will not be conducted and will be treated as a late cancellation. A $150 late cancellation fee will be charged to the on-file payment method.

To provide advance written authorization for a designated individual, please request a Minor Medical Consent Form from our staff.

Parental Access to a Minor's Treatment Information

As the parent or legal guardian of a minor patient, you may be legally entitled to certain information about your child's treatment. Everlong will work with you to determine what information is appropriate to share, while also considering the minor's privacy interests and the integrity of the therapeutic relationship.

Termination of Treatment

Either party may discontinue treatment at any time. If you wish to end your care with Everlong, please notify us through the patient portal or by contacting us at support@geteverlong.com.

Everlong may discontinue treatment if it is no longer clinically appropriate, if you miss three consecutive sessions without notice or fail to reschedule within a reasonable time, or if there is an unresolved outstanding balance on your account. If you wish to seek care from another provider, we may be able to provide referrals to qualified registered dietitians upon request.

Insurance, Billing, and Payment Authorization

By acknowledging this Agreement, you authorize Everlong to submit insurance claims on your behalf to the insurance company or companies you have provided. This authorization includes the release of information necessary to obtain payment for services rendered, including information about your sessions and clinical care. You assign all applicable insurance benefits to Everlong, if accepted, and authorize your insurance company or other third-party payers to make payment directly to Everlong.

You understand and agree that:

• You remain responsible for all amounts not covered by insurance, including copays, coinsurance, deductibles, and any fees for services not covered by your plan.
• Insurance coverage is not guaranteed. Everlong will make reasonable efforts to verify your benefits prior to your first session, but verification is not a guarantee of payment. See the Everlong Guarantee below for our commitment regarding retroactive coverage issues.
• If your account has an outstanding balance that remains unpaid, Everlong reserves the right to suspend services until the balance is resolved. We will notify you before suspending services and work with you in good faith to address any billing questions or disputes.
• Your credit or debit card on file may be charged for no-show and late cancellation fees in accordance with the policy above, and for any out-of-pocket amounts owed for sessions rendered.
• You certify that you are an authorized user of any credit or debit card provided, and you agree not to dispute charges that correspond to the terms of this Agreement.
• You understand that credit card transactions may be associated with Protected Health Information.
• This authorization remains in effect until you cancel it in writing. Please notify Everlong of any changes to your payment or insurance information promptly.

The Everlong Guarantee

You will never be asked to pay for past sessions if an insurance coverage issue is discovered after the fact. If we find that your sessions are not fully covered, we will notify you promptly. You will not owe anything for sessions already completed, and you can decide whether you want to continue with future sessions and pay out of pocket.

Out-of-Network Billing Disclosure

Everlong works with many insurance plans, but we may be considered out-of-network with some carriers. If we are out-of-network with your plan, your sessions may be subject to different cost-sharing terms, including higher deductibles or coinsurance, or may not be covered at all. We will make reasonable efforts to inform you of your estimated out-of-pocket costs before your first session. If a coverage issue is discovered after sessions have already taken place, the Everlong Guarantee applies — you will not be responsible for those past sessions. By acknowledging this Agreement, you confirm that you understand insurance coverage is not guaranteed and that you remain responsible for any amounts not covered by your plan for future sessions you choose to continue.

PROTECTED HEALTH INFORMATION (HIPAA)

THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Pledge Regarding Your Health Information

We recognize that your health information is personal and confidential, and we are committed to protecting it. We create and maintain records of the care and services you receive from us to ensure quality care and meet legal requirements. This notice applies to all records generated by Everlong in connection with your care.

We are required by law to:

• Keep your Protected Health Information ("PHI") private.
• Provide you with this notice describing our legal duties and privacy practices.
• Follow the terms of this notice as currently in effect.
• Update this notice when necessary and make any updated version available upon request.

1. Use and Disclosure of Health Information

The following categories describe the ways we may use and disclose your health information. Not every use or disclosure will be listed, but all permitted uses and disclosures will fall within one of these categories.

Treatment. We may use and disclose your PHI to provide, coordinate, and manage your care. This includes consultations between providers, referrals to other healthcare professionals, and coordination of services. Disclosures for treatment purposes are not subject to the minimum necessary standard, as other providers may need access to your full record to deliver quality care.

Payment. We may use or disclose your PHI to obtain payment for services rendered, including submitting claims to your insurance company and resolving billing inquiries.

Health Care Operations. We may use your PHI for internal operations necessary to run our practice, including quality assessment, auditing, clinical supervision, and administrative functions.

Disclosures with Your Explicit Consent. We may disclose your PHI to third parties — such as family members or other providers not directly involved in your care — if you provide explicit written or documented consent.

Legal Proceedings. We may disclose your PHI in response to a court or administrative order, subpoena, or other lawful legal process. Where feasible, we will notify you before making such a disclosure or seek a protective order.

2. Uses and Disclosures That Require Your Authorization

We maintain clinical notes related to your care ("Session Notes"). Any use or disclosure of Session Notes requires your written authorization, except in the following circumstances:

1. Treatment by our clinical team or coordination with other healthcare providers involved in your care.
2. Training or supervising Everlong staff to improve clinical skills.
3. Legal proceedings initiated by you in which we are defending ourselves.
4. Compliance investigations by the Secretary of Health and Human Services.
5. Disclosures required by law, limited to what is legally necessary.
6. Health oversight activities related to the originator of the Session Notes.
7. Duties of a coroner authorized by law.
8. Averting a serious and imminent threat to the health or safety of you or others.

We will not use or disclose your PHI for marketing purposes without your written authorization. We will not sell your PHI.

3. Uses and Disclosures That Do Not Require Your Authorization

Subject to applicable legal limitations, we may use or disclose your PHI without your authorization in the following circumstances:

1. When required by state or federal law.
2. To report suspected abuse (child, elder, or dependent adult) or to prevent or reduce a serious threat to health or safety.
3. For audits, investigations, or oversight activities.
4. In response to court or administrative orders. We prefer to obtain your authorization where possible.
5. To report crimes occurring on our premises.
6. To cooperate with coroners or medical examiners performing duties authorized by law.
7. For research purposes conducted under appropriate ethical oversight and HIPAA safeguards.
8. For purposes such as military or national security operations, as required by law.
9. To comply with workers' compensation laws.
10. To remind you of upcoming sessions or inform you about treatment alternatives or healthcare services we offer.

4. Uses and Disclosures Requiring an Opportunity to Object

We may share your PHI with a family member, friend, or other person involved in your care or the payment for your care, unless you object. In emergency situations where we cannot obtain your consent in advance, we may share information as necessary and seek your consent retroactively.

5. Your Rights Regarding Your PHI

A. Right to Request Restrictions: You may request that we limit how we use or disclose your PHI for treatment, payment, or healthcare operations. We are not required to agree to all requests but will consider each carefully. We are required to agree to restrictions on disclosures to health plans where you have paid for the relevant services out of pocket in full.

B. Right to Confidential Communications: You may request that we contact you in a specific way or at a specific location. We will accommodate all reasonable requests.

C. Right to Access Your PHI: Except for Session Notes, you have the right to obtain a copy of your medical record and other health information we hold about you. We will provide a copy or summary within 30 days of a written request. A reasonable, cost-based fee may apply.

D. Right to an Accounting of Disclosures: You may request a list of instances in which we have disclosed your PHI for purposes other than treatment, payment, healthcare operations, or pursuant to your authorization. We will respond within 60 days and provide a list covering the prior six years, or a shorter period if you request. The first list in any 12-month period is provided at no charge; a reasonable fee may apply for additional requests.

E. Right to Amend Your PHI: If you believe your PHI is inaccurate or incomplete, you may request an amendment. We may deny the request but will provide a written explanation within 60 days.

F. Right to a Copy of This Notice: You may request a paper or electronic copy of this notice at any time.

Acknowledgment of HIPAA Notice

By acknowledging this Agreement, you confirm that you have received, read, and understood this HIPAA Notice of Privacy Practices, and that you agree to its terms as they apply to your care at Everlong.

CONSENT TO TREAT, WAIVER, AND RELEASE

Informed Consent for Nutrition Counseling

You are engaging Everlong to receive information and guidance on health factors within your control — including diet, nutrition, and related behaviors — to support your overall health and wellness goals.

You acknowledge that Everlong's providers are registered dietitians, not physicians. They do not provide medical advice, diagnose conditions, or prescribe treatments. They offer evidence-based nutritional counseling and educational support to help you understand how food, dietary choices, and eating behaviors affect your health. Nutritional counseling complements but does not replace medical care. You are encouraged to continue working with your primary care provider or other medical professionals as appropriate.

You understand that no guarantees are made regarding the results or outcomes of the nutrition counseling provided by Everlong's registered dietitians. Nutritional assessments conducted during counseling are not intended to diagnose disease; they are designed to guide the development of a health-supportive plan and to monitor your progress.

By acknowledging this Agreement, you agree to hold Everlong harmless from claims or damages related to the services provided, subject to the limitations set forth herein, and you release Everlong from potential liability to the extent permitted by applicable law.

Consent for Telehealth Services

Everlong delivers nutrition counseling services via telehealth — the use of secure, interactive video technology to connect you with your registered dietitian remotely. By acknowledging this Agreement, you consent to receiving your care through telehealth.

You acknowledge that your dietitian has explained, or will explain, how telehealth will be used throughout your engagement with Everlong. You are aware that telehealth technology involves certain inherent risks, including:

• Video or audio connectivity issues that may disrupt or delay a session.
• Transmission quality limitations that may affect the clarity of communication.

Telehealth also offers meaningful benefits, including:

• Eliminating the need to travel to an in-person location.
• Providing access to specialized care that may not be locally available.

Video Platform

Everlong conducts telehealth video sessions using Zoom, accessed through the patient portal. By acknowledging this Agreement, you agree to the following:

• Zoom is not an emergency service. In the event of any emergency, call 911 immediately.
• Zoom facilitates video conferencing only and is not responsible for delivering healthcare, medical advice, or clinical care. Your registered dietitian is not responsible for any technical information within Zoom, and Zoom data should not be relied upon for clinical purposes.
• To protect the confidentiality of your session, you agree not to share your session link with any person who is not authorized to attend.
• Everlong may update the video platform used for telehealth sessions. You will be notified of any such change in advance.

GENERAL TERMS

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of Delaware, without regard to its conflict of law principles. Any legal action or proceeding arising out of or related to this Agreement shall be brought exclusively in the federal or state courts located in New Castle County, Delaware, and you irrevocably consent to the jurisdiction and venue of such courts.

Severability

If any provision of this Agreement is found to be invalid or unenforceable by a court of competent jurisdiction, the remaining provisions will continue in full force and effect.

Entire Agreement

This Agreement, together with Everlong's Privacy Policy, Terms of Use, and Communication Policy, constitutes the entire agreement between you and Everlong with respect to your care and use of the Services. In the event of a conflict between this Agreement and any other Everlong policy with respect to your clinical care or health information, this Agreement controls.

Updates to This Agreement

Everlong may update this Agreement from time to time. If material changes are made, we will notify you and may ask you to re-acknowledge the updated Agreement before continuing to use the Services.

Contact Us

If you have questions about this Agreement, please contact us at support@geteverlong.com.

BY ACKNOWLEDGING OR SIGNING THIS AGREEMENT DURING SIGNUP, YOU CONFIRM THAT YOU HAVE READ, UNDERSTOOD, AND AGREED TO ALL TERMS CONTAINED IN THIS DOCUMENT.