Consumer Health Data Policy

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Your Rights

You have the right to: 

• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we: 

• Tell family and friends about your condition
• Provide disaster relief
• Include you in a hospital directory
• Provide mental health care
• Market our services and sell your information
• Raise funds

Our Uses and Disclosures

We may use and share your information as we: 

• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Do research
• Comply with the law
• Respond to organ and tissue donation requests
• Work with a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions

To the extent that we have your substance use disorder patient records, subject to 42 CFR part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record 

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. 
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

• You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address. 
• We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no,” for example, if it could affect your care. If we agree to your request, we may still share this information in the event that you need emergency treatment.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

• If someone has authority to act as your personal representative, such as if someone has your medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

• You can complain if you feel we have violated your rights by contacting us using the information on page 1.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html.
• We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care or payment for your care
• Share information in a disaster relief situation
• Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

In the case of fundraising:

• We may contact you for fundraising efforts, but you can tell us not to contact you again. 

If we have your substance use disorder patient records, subject to 42 CFR part 2, we will give you clear and obvious notice in advance and a choice about whether to receive fundraising communications that use your Part 2 information. 

Our Uses and Disclosures

How do we typically use or share your health information? 

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services. 

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities. 

Example: We give information about you to your health insurance plan so it will pay for your services. 

How else can we use or share your health information? 

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.  

In all cases, including those listed below, if we have substance use disorder patient records about you, subject to 42 CFR part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.

Help with public health and safety issues

We can share health information about you for certain situations such as: 

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

‍Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official 
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

• We can share health information about you in response to a court or administrative order, or in response to a subpoena. 

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information. 
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it. 
• We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. 

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

Other State and Federal Laws

We may ask you for consent to share certain medical information. This consent is required by applicable state law for some disclosures and allows us to be certain that we can share your medical information for all of the reasons explained in this notice. For example, we will ask for your consent to share your information for payment purposes. We may also ask for your consent to share certain sensitive information that may have extra protection under state or federal laws.

This Notice of Privacy Practices applies to the following organizations: Receptive Inc., dba Pettable

Effective date: Feb 16th 2026

Privacy@pettable.com

+1 (855) 920-0323

These Service Terms constitute a legal agreement between you and Pettable, Inc. (“Pettable”, or “us”) regarding your use of our services.  PLEASE READ THESE SERVICE TERMS CAREFULLY BEFORE USING OUR SERVICES.  THEY CONTAIN IMPORTANT INFORMATION REGARDING YOUR LEGAL RIGHTS, INCLUDING A WAIVER OF THE RIGHT TO A JURY TRIAL. BY CLICKING “I ACCEPT” AS PART OF THE REGISTRATION PROCESS YOU AGREE TO BE LEGALLY BOUND BY: 

• These Service Terms and 
• The Telehealth Consent Documents, consisting of (a) your Informed Consent for Tele-Therapy Services,  (b) your HIPAA Authorization to Share Health Information, (c) any other agreements entered into for Veterinary Services, as defined below; and (d) any other documents or policies linked or referenced in these Service Terms.  

‍

IF YOU DO NOT AGREE WITH THESE SERVICE TERMS OR THE TELEHEALTH CONSENT DOCUMENTS, DO NOT USE THE PETTABLE SERVICES OR THE PETTABLE PLATFORM. 

1. Defined Terms.  Section 27 (Definitions) provides the defined terms used in this Agreement.  
2. Pettable Services and Platformsome text
   1. Pettable Services and the Platform. Pettable has developed a network of licensed mental health professionals and facilitates your access to a provider in this network to determine whether you qualify for an Emotional Support Animal (“ESA”) letter or a Psychiatric Service Dog (“PSD”) letter and, if so, to provide you with one of these letters. The licensed mental health professionals in the Pettable Network (each a “Network Provider”) provide telehealth services, which may include assessment, diagnosis, therapy, follow-up and/or education, teletherapy, consultation, treatment, transfer of personal and health information, emails, telephone conversations and education using interactive audio, video and data communications, as applicable (“Telehealth Services”). Pettable also offers to you the ability to access certain on demand veterinary services through the Pettable Platform or by calling into the veterinary assistance helpline (the “Veterinary Helpline”) at 833-849-9559  for your ESA or PSD (“Veterinary Services”). After contacting the Veterinary Helpline you will receive assistance and advice from a veterinary nurse or veterinarian (“Veterinary Provider”). If the Veterinary Provider determines that video support or additional documentation such as pictures of your PSD or ESA, such portion of the Veterinary Services will be provided either through the Pettable Platform or your Veterinary Provider may provide you with an individual link to access the video conference or to upload images or videos requested by the Veterinary Provider. After collecting intake information from you, Pettable will facilitate your access to one of our Network Providers and provide administrative services to assist with and manage this relationship (“Administrative Services”). Administrative Services, Telehealth Services, and Veterinary Services are collectively referred to as the “Pettable Services”. 
   2. Veterinary Services. Veterinary Services may be made available to you at an additional cost and cannot be purchased as a standalone service without the purchase of Telehealth Services and Administrative Services. Payment for the Veterinary Services shall be made in accordance with Section 8 of this Agreement. You may purchase the additional Veterinary Services at any time through our website or during your initial registration process.  You acknowledge that (a) Veterinary Services will be provided remotely, and (b) that the Veterinary Provider may be located outside of the United States and does not provide medical, behavioral health, or health advice or diagnoses.
   3. ESA Letter Value Bundle Subscription.  If you elect to subscribe  for Pettable’s ESA Letter Value Bundle Subscription, your subscription will include the following services and products until your subscription is terminated:  (i) access to Pettable Services to determine whether you qualify for an ESA letter or PSD letter, (ii) access to Veterinary Services, (iii) free renewals of your ESA letter or PSD letter, as applicable, for as long as your ESA Letter Value Bundle Subscription is active, fully paid, and in good standing, and (iv) a one-time opportunity to request and receive a $15.00 Amazon gift card from Pettable within thirty (30) days of signing up for the ESA Letter Value Bundle Subscription. To activate your access to Veterinary Services, you must contact support@pettable.com. To receive the $15.00 Amazon gift card described, you must contact support@pettable.com on or before the date that is thirty (30) days after you sign up for your ESA Letter Value Bundle Subscription (and, if you fail to timely do so, you will not be entitled to the $15.00 Amazon gift card). 
3. Relationship between Network Providers and Pettable. Pettable does not itself provide any therapy, Telehealth Services, or other Network Providers’ services. All of the Network Providers are independent of Pettable. Any information or advice received from a Network Provider comes from them alone, and not from Pettable. Pettable does not make any representations or warranties about the training or skill of any Network Providers.
4. Access License.  some text
   1. Access Rights. Subject to the terms and conditions of this Agreement, Pettable hereby grants to you, under Pettable’s Intellectual Property Rights and during the Term, a non-exclusive, non-sublicensable, non-transferable license to access and use the Pettable Platform for its intended purposes.  
   2. Ownership of Pettable Platform. As between the Parties, the Pettable Platform (and Intellectual Property Rights embodied in the Pettable Platform) are the sole property of Pettable and, except for the limited rights granted in this Section 4 (Access License), you have no rights in or to the Pettable Platform. 
   3. Restrictions. You agree that you will not: (i) sell, rent, lease, sublicense, transfer, modify, create derivative works of, or redistribute the Pettable Platform; (ii) alter or remove any copyright, patent, trademark, or other protective notices included with the Pettable Platform; (iii) reverse engineer, decompile, or disassemble the Pettable Platform; or (iv) allow any party other than itself to access or otherwise use the Pettable Platform and Pettable Services. 
   4. No Implied Rights. No rights shall be implied under this Agreement, based on any course of conduct, or on any construction or interpretation thereof. All rights and licenses not expressly granted in this Agreement are reserved.
5. Helpdesk Support. Pettable provides FAQs and other documentation, located at www.pettable.com, to answer questions concerning the Pettable Services. If these materials do not answer your question, please feel free to contact us as set forth in Section 26 (Contact Us).  
6. Availability. Pettable shall use commercially reasonable efforts to make the Pettable Platform available to the you, subject to reasonable downtime for maintenance and error corrections.
7. Acceptable Use Policy.  You shall not: (i) use the Pettable Platform for purposes that are unlawful, offensive, infringing the privacy of others, or otherwise prohibited by this Agreement; (ii) use the Pettable Platform in a manner designed to disable, overburden, or impair the Pettable Platform or interfere with another party’s use and enjoyment of the Pettable Platform (or its components); (iii) seek to obtain access to any portion of the Pettable Platform or related materials, accounts, or information through hacking, data harvesting, data mining, or through other means Pettable has not intentionally made available to the you through the Pettable Platform; or (iv) infringe Pettable’s or any third-party’s Intellectual Property rights, or other proprietary rights or rights of publicity or privacy.  
8. Payment Terms. You shall pay Pettable the fees associated with your use of the Pettable Services and identified on the Website (collectively, the “Fees”). The Fees will be paid by you either (i) with one upfront payment at the time you complete the initial questionnaire to access the Pettable Services, or (ii) on a recurring basis as described on the Website if you sign up for Pettable’s ESA Letter Value Bundle Subscription. Unless expressly otherwise provided herein, all Fees are stated and payable in U.S. dollars. Pettable does not accept health insurance for payment for any Pettable Services. some text
   1. Payment Authorization. By providing Pettable with credit card information, a Google Pay account, an Apple Pay account, or other payment method we offer, you agree that Pettable is authorized to immediately charge your account for Fees due and payable to Pettable with no additional notice or consent required (including on a recurring basis as described on the Website if you sign up for Pettable’s ESA Letter Value Bundle Subscription). 
   2. Pricing Modification. Pettable reserves the right to prospectively modify or implement a new pricing structure. Pettable will notify you if a change in pricing takes place during the Term. If you disagree with the new pricing structure, you may terminate this Agreement according to Section 18 (Termination). 
   3. Pettable Fees. You understand that the portion of the Fees attributed to the Telehealth Services provided by Network Providers is passed through by Pettable to the Network Provider rendering the Telehealth Services to you and is not retained by Pettable.  The portion of the fees retained by Pettable is for the fair market value of the Administrative Services provided by Pettable.
   4. Taxes. All Fees payable hereunder are exclusive of, and, as between the Parties, you are responsible for paying, any taxes assessed or imposed in connection with this Agreement (excluding taxes on Pettable's income or property). You shall indemnify and hold Pettable harmless from and against all claims and liabilities arising in connection with your failure to report or pay any such taxes. 
9. Feedback. The term “Feedback” means suggestions, ideas, feature requests, and recommendations made by you relating to Pettable Services or other elements of Pettable’s business. If you choose to provide Feedback to Pettable, then you hereby transfer to Pettable your rights in Feedback (including associated Intellectual Property Rights).
10. Privacy and Telehealth Consent Documents. Your use of the Pettable Services may result in Pettable’s processing, on your behalf, personal health information (“PHI”) included in the Customer Data and some information Pettable collects constitute PHI. These processing activities and the maintenance and disclosure of such PHI will be subject to the Informed Consent for Tele-Therapy Services and HIPAA Authorization to Share Health Information (the “Telehealth Consent Documents”). In case of a conflict between this Agreement and the Telehealth Consent Documents or any business associate agreement entered into by Pettable, as discussed below, the Telehealth Consent Documents, applicable law, and any business associate agreements shall control.  Your Network Provider, if a covered entity under the U.S. Health Insurance Portability and Accountability Act (“HIPAA”), will provide you with a Notice of Privacy Practices describing its collection, use and disclosure of your PHI, not Pettable.  Pettable, in some instances, is a “business associate” (as that term is used under HIPAA) that provides services to and for the Network Providers, referred to as “covered entities” under HIPAA, and enters into business associate agreements with those Network Providers that are covered entities. When applicable, Pettable will use and disclose PHI only in accordance with any such business associate agreements and HIPAA.  We may de-identify your Personal Information so that it no longer reasonably identifies you. In this case, we may use this de-identified data without restriction and for any purpose, including to improve our products and services.
11. Customer Data.  some text
    1. Retention of Customer Data.  You are responsible for retaining copies of Customer Data and, except to the extent required by applicable law, Pettable has no obligation to backup Customer Data. 
    2. Security. Pettable shall use commercially reasonable efforts to safeguard the security of Customer Data resident on the Pettable Platform, and shall employ, for this purpose, information security controls consistent with accepted practice in the industry and applicable law.
12. Representations and Warranties.  Unless provided otherwise in other Terms, the Parties represent and warrant as follows: some text
    1. Your Representations and Warranties. You represent and warrant to Pettable: (i) that you have provided true and accurate information and will maintain the accuracy of such information; (ii) that you are physically located in and reside in the state indicated in the address you provided during the registration process, as the licensed mental health professional cannot assess across state lines; (iii) that you will comply with applicable law; and (iv) that you are solely responsible for knowing and understanding your local laws concerning standards for the content, legality, and requirements for ESA/PSD Letters. 
    2. Pettable Representations and Warranties. Pettable represents and warrants to you: (i) that the Administrative Services, PSD Training Course, and Pettable Academy Courses will be performed in accordance with accepted industry practice and by qualified individuals; and (ii) that it has used reasonable care and practice in evaluating and selecting the mental health professionals who administer the Telehealth Services and comprise the Pettable Network, and the certified professional dog trainers who conduct the PSD Training Course and Pettable Academy Courses.  While we make efforts to verify the background that the Network Providers and certified professional dog trainers claim they have, we cannot warrant or guarantee their accuracy.
    3. Disclaimer of Warranties. EXCEPT AS EXPRESSLY SET OUT IN SECTION 12.2 (Pettable Representations and Warranties), THE PETTABLE SERVICES, PETTABLE PLATFORM, AND ALL PETTABLE PERFORMANCE OBLIGATIONS ARE PROVIDED “AS IS” WITHOUT WARRANTY OF ANY KIND, AND PETTABLE HEREBY EXPRESSLY DISCLAIMS ALL OTHER REPRESENTATIONS AND WARRANTIES OF ANY KIND, WHETHER EXPRESS OR IMPLIED, ORAL OR WRITTEN, INCLUDING WITHOUT LIMITATION, ALL IMPLIED WARRANTIES OF TITLE, NON-INFRINGEMENT, QUIET ENJOYMENT, ACCURACY, INTEGRATION, MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE, AND ALL WARRANTIES ARISING FROM ANY COURSE OF DEALING, COURSE OF PERFORMANCE, OR USAGE OF TRADE.  THE FOREGOING DOES NOT AFFECT WARRANTIES THAT CANNOT BE EXCLUDED OR LIMITED UNDER APPLICABLE LAW.
13. Additional Disclaimers. some text
    1. Not a Licensed Healthcare Provider. Pettable is not a licensed health care provider nor does Pettable provide medical, behavioral health, or health advice or diagnoses. Any medical advice or treatment you receive in connection with the Pettable Services is provided by our Network Providers. Always seek professional medical advice regarding a medical or mental health condition or treatment.  
    2. No Therapist – Patient Relationship. All information provided by Pettable is intended to be for general informational purposes only, and is in no way intended to create a therapist – patient relationship as defined by state and federal law.  While Pettable facilitates your selection of, communications with and other interactions with Network Providers, Pettable does not provide professional services and the therapist-patient relationship is between you and the therapy provider you select. Pettable shall not be liable for any professional advice obtained from a Network Provider or for any other information obtained on the Pettable Platform. Pettable receive a fee from Network Providers for use of the Platform and technology and various other services. However, this does not imply endorsement of a particular Network Provider.  Pettable shall not be liable for negligent credentialing or the negligence of any Network Provider.  Pettable does not endorse any specific tests, providers, therapies, products or procedures that are recommended by Network Providers. You acknowledge that your reliance on any healthcare providers or information provided by the Network Providers is solely at your own risk and you assume full responsibility for all risk associated herewith.  The content of the site and the services, including without limitation, text, copy, audio, video, photographs, illustrations, graphics and other visuals, is for informational purposes only and does not constitute professional medical or behavioral health advice, diagnosis, treatment or recommendations of any kind. You should always seek the advice of your qualified heath care professionals with any questions or concerns you may have regarding your individual needs and any medical or behavioral health conditions.  We do not guarantee that any person’s use of the Pettable Platform is the appropriate course of treatment for any individual’s particular health care problem. 
    3. Not an Emergency-Monitoring Service or Crisis Service. Pettable is not an emergency-response, emergency-monitoring service, or crisis service. Any person who is aware of an emergency situation should immediately contact an appropriate emergency response or dial “911”.  Any person who is feeling suicidal or in need of immediate assistance due to emotional crisis should reach out for help to a crisis help line. A list of crisis help lines and service providers can be found in your phone book, or contact the National Suicide Hotline 800-273-TALK (800-273-8255).  If you are in crisis, contact the above organizations or another resource of your choice.  If you need help finding mental health services and support in your community contact an appropriate organization, such as for example: National Mental Health Association Information Center: nmha.org. 
    4. No Assurances of Acceptance. Except as expressly provided in Section 15 (Refund), Pettable does not guarantee that a landlord, airline, or other third party will follow the requirements set by state and/or federal laws and regulations that govern ESAs and PSDs, or will accept your ESA/PSD Letter.  Even though a person may have an ESA/PSD Letter from a Network Provider, this in no way guarantees that the person will qualify as “disabled” under federal or state law, or receive any particular accommodation by any airline, hotel, restaurant owner, or any other company or individual. An ESA is not a “service dog” as defined by law and may not necessarily be accorded the same level of accommodation.  
    5. PSD Training Course and Pettable Academy Courses.  Pettable offers the PSD Training Course as a tool to educate you about PSDs and to assist you in training your PSD and offers additional self-guided dog training through Pettable Academy Courses; however, Pettable is not responsible for training any Animal Companion as a PSD or for otherwise training or assisting you with training any dog.  If you purchase the Pettable Academy Courses, you acknowledge, agree, and understand that the Pettable Academy Courses are self-guided and that the success of those Pettable Academy Courses is contingent on your own effort to complete the Pettable Academy Courses and to follow and adhere to the instructions and information provided therein (including any personalized training recommendations that may result from live support sessions).  The PSD Course Completion Certificate issued upon your completion of the PSD Training Course does not certify or guarantee that your Animal Companion qualifies as a PSD; rather, it solely certifies your completion of the PSD Training Course offered by Pettable.  Similarly, the Pettable Academy Completion Certificate issued upon your completion of the Pettable Academy Courses do not certify or guarantee anything about your dog other than the fact that you and your dog completed such Pettable Academy Courses.  Pettable is not responsible for any damages caused by your Animal Companion in public or private spaces or for the behavior of your Animal Companion before or after you complete the PSD Training Course or Pettable Academy Courses and receive a PSD Course Completion Certificate or Pettable Academy Completion Certificate.  The PSD Course Completion Certificate and Pettable Academy Completion Certificate do not provide protection against liability for misconduct by your Animal Companion.
    6. Animal Companion. Without limiting Section 12.3 (Disclaimer of Warranties), Pettable is not responsible for the training, temperament, or qualification of any Animal Companion as a service animal.  Pettable is not responsible for any damages caused by the Animal Companion in public or private spaces. An ESA/PSD letter does not provide protection against liability for misconduct by the Animal Companion. 
    7. Legal Disclaimer.  Pettable is not a lawyer or a law firm and does not provide any legal advice. The Pettable Platform neither offers nor constitutes legal advice or counsel. The Pettable Platform may contain content (such as the PSD Training Course and Pettable Academy Courses) that references federal, state and local rules regarding assistance animals and/or telehealth. Pettable does not make any representations or warranties as to the accuracy or applicability of this content. Laws, regulations, guidelines and other rules regarding ESAs, PSDs, assistance animals and telehealth are constantly evolving and subject to interpretation, and Pettable makes no representations or guarantees as to whether any information on the Pettable Platform is current, complete, accurate or relevant or that the Telehealth Services comply with applicable local, state and/or federal laws. Content on the Pettable Platform is not regularly updated. You should not rely on any content on the Pettable Platform for any advice, guidance or information of a legal nature. To answer legal questions, you should always seek help from a licensed professional or directly reference the latest federal, state or local rules applicable to your circumstance. Pettable makes no representation that any ESA/PSD Letter provided by a Network Provider or Telehealth Services comply with applicable local, state or federal laws.  
14. Indemnification. You shall defend and indemnify us against any third party claim, action, suit, or proceeding resulting from your use of the Pettable Services in a manner not expressly authorized by this Agreement. We shall notify you of any such claim and provide reasonable cooperation and assistance in connection with the claim, at your expense. You will not enter into any settlement without our prior approval, not to be unreasonably withheld. 
15. Refund.   some text
    1. Denied Accommodation. Pettable will refund your Fees applicable to the Telehealth Services and Administrative Service, but not the Veterinary Services, if each of the following conditions are met: (i) you are denied an accommodation by a landlord or property manager  due to a claim that the ESA/PSD Letter from Pettable is not valid; (ii) you have filed a complaint with HUD concerning this denial and provided proof of the filing to us; (iii) you have submitted acceptable documentation of the landlord’s denial (or property managers’ denial) to Pettable (via email to support@pettable.com) within sixty (60) days of the denial; (iv) all information provided to Pettable under this Agreement is complete, accurate and valid; and (v) you have attended each required appointment, consultation and training required to properly receive the Pettable Services. If you receive a refund of your Fees under this Section 15.1 and you have purchased Veterinary Services, your subscription for Veterinary Services will not terminate until terminated in accordance with Section 18 of these Service Terms. 
    2. Failure to Qualify for ESA/PSD Letter. If the Network Provider determines that you do not qualify for an ESA/PSD Letter, Pettable will refund your Fees if you submit your rejection letter to Pettable (via email to support@pettable.com) within thirty (30) days of the Network Provider’s determination.  
    3. Dissatisfaction with PSD Training Course or Pettable Academy Courses. If you purchase the PSD Training Course or Pettable Academy Courses, are dissatisfied with the PSD Training Course or Pettable Academy Course materials provided, and submit a written request to Pettable (via email to support@pettable.com) on or before the date that is 7 days after you purchased the PSD Training Course or Pettable Academy Courses explaining why you are dissatisfied with the PSD Training Course or Pettable Academy Course materials and requesting a refund of the Fee for the PSD Training Course or Pettable Academy Courses, Pettable will refund your Fee paid for the PSD Training Course or Pettable Academy Courses, as applicable (but no other Fees).  
    4. Limitations to Refund.  You will not be entitled to receive a refund except in the circumstances specified in Section 15.1 (Denied Accommodation), Section 15.2 (Failure to Qualify for ESA/PSD Letter), and Section 15.3 (Dissatisfaction with PSD Training Course or Pettable Academy Courses). For example, Pettable will not issue a refund: (i) if you do not schedule or attend a consultation appointment with a Network Provider; or (ii) if you decide not to continue with the Pettable Services before fully completing the ESA/PSD process.
16. Limitation of Liability. IN NO EVENT SHALL PETTABLE BE LIABLE FOR ANY INDIRECT, PUNITIVE, SPECIAL, OR CONSEQUENTIAL DAMAGES OF ANY KIND, INCLUDING WITHOUT LIMITATION, LOSS OF PROFITS; LOSS OF DATA; OR LOSS OR INTERRUPTION OF USE; EVEN IF PETTABLE HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. PETTABLE’S LIABILITY FOR DAMAGES WILL EXCEED, IN THE AGGREGATE, AN AMOUNT EQUAL TO THE FEES YOU HAVE PAID TO PETTABLE.
17. Term.  The Agreement shall commence as of the Effective Date and, unless earlier terminated in accordance with Section 18 (Termination), shall continue until the later of (i) your receipt of a requested ESA/PSD Letter; (ii) the Network Provider’s decision to decline your request for an ESA/PSD Letter; (iii) expiration of the guarantee period, if applicable, provided for in Section 15 (Refund); (iv) your cancellation of the Veterinary Services, if applicable; or (v) the date on which you or Pettable terminate your ESA Letter Value Bundle Subscription (the “Term”). 
18. Termination. some text
    1. Termination for Convenience. You may terminate this Agreement for any reason (or no reason) prior to the expiration of the Term upon notice to Pettable; provided you have completely fulfilled your payment obligations under Section 8 (Payment Terms). Terminating under this Section 18.1 (Termination for Convenience) will not entitle you to a refund, unless you otherwise qualify for the refund  under Section 15 (Refund). If you elect to terminate just the Veterinary Services under this Section 18.1 (Termination for Convenience), the remainder of the Pettable Services are not automatically terminated and will remain subject to the terms of this Agreement until otherwise terminated.  
    2. Termination for Material Breach. Either Party shall be entitled to terminate this Agreement for material breach by the other, upon providing notice to the other Party.
    3. Termination of Veterinary Services. You will be charged monthly for Veterinary Services until  you request a cancellation of your Veterinary Services by contacting Customer Services at support@pettable.com. Termination of Pettable Services other than Veterinary Services does not automatically terminate Veterinary Services. In the month following your confirmed cancellation of Veterinary Services, Pettable will cease to charge for Veterinary Services and your access to the Veterinary Services will immediately terminate. 
    4. Termination of ESA Letter Value Bundle Subscription. If you intend to terminate your ESA Letter Value Bundle Subscription, you must contact Pettable at support@pettable.com and specifically request the termination of your entire ESA Letter Value Bundle Subscription and this Agreement.  If you terminate one component of the ESA Letter Value Bundle Subscription, it shall not constitute termination of your entire ESA Letter Value Bundle Subscription unless you specifically request in writing to Pettable that your ESA Letter Value Bundle Subscription terminate.
    5. Suspension of Service. Pettable shall be entitled to suspend or terminate your account immediately and without notice if Pettable determines, in its sole judgment, that you are in breach of this Agreement or your continued use would have a material and adverse impact on Pettable or any of its users. 
    6. Effect of Termination or Expiration. Immediately upon termination or expiration of this Agreement: (i) Pettable shall cease providing the Pettable Services; and (ii) all of your licenses under this Agreement shall end. Pettable may retain copies of the your PHI and other Customer Data to the extent required for legal compliance and copies to the extent the same resides on backup servers. The expiration or termination of this Agreement shall not affect any obligation that accrued prior to such expiration or termination.
    7. Survival. The following Sections of this Agreement shall survive any termination or expiration of this Agreement: (i) Section 4.2 (Ownership of Pettable Platform); (ii) Section 5 (Customer Data); (iii) Section 9 (Feedback); (iv) Section 14 (Indemnification) (v) Section 16 (Limitation of Liability); and (vi) Section 22 (Statistical Data). 
19. Notices. All notices under this Agreement shall be in writing,  in English, and delivered by email.  Notices to Pettable shall be deemed duly delivered upon Pettable’s receipt of your email at the email address specified in Section 26 (Contact Us). Notices to you shall be deemed duly delivered upon your receipt of Pettable’s at the email address you provided during the registration process.
20. Amendment or Assignment.  No amendment to or assignment of this Agreement will be effective unless consented to in writing by both Parties.  
21. No Waiver. No failure or delay in exercising any right under this Agreement will operative as a waiver of such right, or preclude any further exercise.  
22. Statistical Data. To the extent not prohibited by applicable law, Pettable shall be entitled to collect, compile, analyze, and otherwise use and exploit statistical and usage data related to the use of the Pettable Platform and Pettable Services that has been de-identified in accordance with applicable law (“Statistical Data”). No compensation shall be paid by Pettable with respect to its use of the Statistical Data. 
23. Subcontracting. Pettable shall be entitled to use subcontractors in the performance of Pettable’s obligations under this Agreement; provided, however, that if Pettable engages subcontractors, then Pettable shall remain liable for all obligations under this Agreement as though no such subcontracting had occurred. Without limitation, any mental health professional within the Pettable Network and any Veterinary Provider is a subcontractor. 
24. Governing Law; Jurisdiction. This Agreement, and all claims, disputes, or controversies arising out of this Agreement, shall be governed in all respects by the laws of Delaware, USA, without giving effect to its conflicts of law provisions. The exclusive venue and jurisdiction for any action or proceeding arising out of this Agreement shall be the state and federal courts located in Wilmington, Delaware, USA. The Parties accept the personal jurisdiction of such courts. 
25. Waiver of Jury Trial; No Class Actions.  Each Party irrevocably and unconditionally waives any right it may have to a trial by jury in respect of any legal action arising out of or relating to this Agreement or the transactions contemplated hereby. You similarly waive rights or authority (if any) to litigate a claim or dispute under or related to this Agreement on a class action or consolidated basis, or in any type of representative capacity on behalf of another person or persons whether or not similarly situated.  
26. Contact Us. To contact us, please email support@pettable.com.
27. Definitions. some text
    1. “Administrative Services” has the meaning set out in Section 2 (Pettable Services and the Platform).
    2. “Agreement” means these Service Terms. 
    3. “Animal Companion” means an animal who provides emotional or physical support for a person. 
    4. “Customer Data” means data, information, and content that the Company (i) uploads to, or makes available to Pettable by means of, the Pettable Platform (including, but not limited to, in connection with the PSD Training Course and Pettable Academy Courses), or (ii) otherwise provides to Pettable.  
    5. “Effective Date” means the effective date of the Agreement, as specified on the account creation.
    6. “Emotional Support Animal” has the meaning set out in Section 2 (Pettable Services and the Platform).
    7. “ESA” has the same meaning as “Emotional Support Animal.” 
    8. “ESA Letter” means a formal letter by a licensed mental health professional designed to qualify your Animal Companion as an ESA.  
    9. “ESA Letter Value Bundle Subscription” has the meaning set forth in Section 2.3 (ESA Letter Value Bundle Subscription).
    10. “ESA/PSD Letter” means (i) an ESA Letter or (ii) a PSD Letter, as the case may be.  
    11. “Fees” has a meaning set out in Section 8 (Payment Terms). 
    12. “Intellectual Property” or “Intellectual Property Rights” means rights under patent law, copyright law, trademark law, data and database protection law, trade secret law, and law applicable to confidential information, and any and all similar proprietary rights. “Intellectual Property Rights” means those rights as they exist as of the Effective Date, and all such rights subsequently acquired during the Term.
    13. “Network Provider” has the meaning set out in Section 2 (Pettable Services and the Platform).
    14. “Personal Data” means information (i) that relates an identified or identifiable natural person, (ii) that may be linked or linkable to such natural person or their household; or (iii) that is defined as personal information or personal data (or the equivalent) under applicable law.
    15. “Personal Health Information” or “PHI” has the meaning set out in the Telehealth Consent Documents. 
    16. “Pettable Academy Courses” means the self-guided training courses offered by Pettable that provide information and instructions regarding how to train a dog and other information related to owning and caring for a dog, such as “Puppy Kindergarten” and “Mastering Focus,” and are included in the scope of Pettable Services.  All references to the Pettable Academy Courses herein shall also refer to and include any optional live support services purchased by you and the evaluation and any personalized training recommendations that result from such live support.
    17. “Pettable Academy Completion Certificate” means the certificate issued by Pettable to you upon your completion of the Pettable Academy Courses. 
    18. “Pettable Network” means the network of licensed mental health professionals chosen by Pettable to administer the Telehealth Services.
    19. “Pettable Platform” means the portal and associated infrastructure that provides the Pettable Services. 
    20. “Pettable Services” has the meaning set out in Section 2 (Pettable Services and the Platform). 
    21. “Psychiatric Service Dog” has the meaning set out in Section 2 (Pettable Services and the Platform).
    22. “PSD” has the same meaning as “Psychiatric Service Dog.”  
    23. “PSD Letter” means a formal letter by a licensed mental health professional designed to qualify your Animal Companion as a PSD.  
    24. “PSD Training Course” means the training course offered by Pettable that provides information and instructions regarding how to train your Animal Companion to become a PSD and other information related to PSDs, and is included in the scope of Pettable Services.
    25. “PSD Course Completion Certificate” means the certificate issued by Pettable to you upon your completion of the PSD Training Course.  
    26. “Statistical Data” has the meaning set out in Section 22 (Statistical Data). 
    27. “Telehealth Consent Documents” has the meaning set out in Section 10 (Privacy and Telehealth Consent Documents).  
    28. “Telehealth Services” has the meaning set out in Section 2 (Pettable Services and the Platform). 
    29. “Term” is defined in Section 17 (Term).
    30. “Website” means the Pettable website located at https://pettable.com/. 
    31. “you” means the individual who clicks “I accept” to this Agreement.

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This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Your Rights

You have the right to: 

• Get a copy of your paper or electronic medical record
• Correct your paper or electronic medical record
• Request confidential communication
• Ask us to limit the information we share
• Get a list of those with whom we’ve shared your information
• Get a copy of this privacy notice
• Choose someone to act for you
• File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we: 

• Tell family and friends about your condition
• Provide disaster relief
• Include you in a hospital directory
• Provide mental health care
• Market our services and sell your information
• Raise funds

Our Uses and Disclosures

We may use and share your information as we: 

• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Do research
• Comply with the law
• Respond to organ and tissue donation requests
• Work with a medical examiner or funeral director
• Address workers’ compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions

To the extent that we have your substance use disorder patient records, subject to 42 CFR part 2, we will not share that information for investigations or legal proceedings against you without (1) your written consent or (2) a court order and a subpoena.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record 

• You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. 
• We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

• You can ask us to contact you in a specific way (for example, home, office, or cell phone) or to send mail to a different address. 
• We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no,” for example, if it could affect your care. If we agree to your request, we may still share this information in the event that you need emergency treatment.
• If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

• If someone has authority to act as your personal representative, such as if someone has your medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

• You can complain if you feel we have violated your rights by contacting us using the information on page 1.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html.
• We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

• Share information with your family, close friends, or others involved in your care or payment for your care
• Share information in a disaster relief situation
• Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

In the case of fundraising:

• We may contact you for fundraising efforts, but you can tell us not to contact you again. 

If we have your substance use disorder patient records, subject to 42 CFR part 2, we will give you clear and obvious notice in advance and a choice about whether to receive fundraising communications that use your Part 2 information. 

Our Uses and Disclosures

How do we typically use or share your health information? 

We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services. 

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities. 

Example: We give information about you to your health insurance plan so it will pay for your services. 

How else can we use or share your health information? 

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.  

In all cases, including those listed below, if we have substance use disorder patient records about you, subject to 42 CFR part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your consent or (2) a court order and a subpoena.

Help with public health and safety issues

We can share health information about you for certain situations such as: 

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

‍Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

• For workers’ compensation claims
• For law enforcement purposes or with a law enforcement official 
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

• We can share health information about you in response to a court or administrative order, or in response to a subpoena. 

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information. 
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it. 
• We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. 

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

Other State and Federal Laws

We may ask you for consent to share certain medical information. This consent is required by applicable state law for some disclosures and allows us to be certain that we can share your medical information for all of the reasons explained in this notice. For example, we will ask for your consent to share your information for payment purposes. We may also ask for your consent to share certain sensitive information that may have extra protection under state or federal laws.

This Notice of Privacy Practices applies to the following organizations: Receptive Inc., dba Pettable

Effective date: Feb 16th 2026

Privacy@pettable.com

+1 (855) 920-0323

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I understand that Pettable will provide administrative services to facilitate connecting me with a licensed mental health professional (“the LMHP”) via our online platform to provide behavioral healthcare, including assessment, diagnosis, therapy, follow-up and/or education teletherapy includes consultation, treatment, transfer of  personal and health information, emails, telephone conversations and education using interactive audio,  video and data communications (“Telehealth”). Telehealth involves the use of electronic communications.  I hereby consent to engage in Telehealth services with my LMHP.  I understand that my LMHP is an independent contractor and is not employed by Pettable.  My LMHP may require me to execute an additional informed consent prior to engaging in Telehealth.

I understand that the expected benefits of Telehealth are improved access to behavioral health care enabling me to  remain at a remote site while the LMHP is at a distant site, more efficient evaluation and management and obtaining the expertise of a distant LMHP who is licensed in the state where I reside. 

I understand that I have a right to confidentiality with Telehealth under the same laws that protect the confidentiality of my personal and health information for in-person behavioral health services. Any information disclosed by me during the course of my remote Telehealth, therefore, is generally confidential to the extent provided by law. 

As with any medical care, there are potential risks associated with the use of Telehealth. These risks  include, but may not be limited to: (a) in rare cases, information transmitted may not be sufficient (e.g. poor resolution of images) to allow for appropriate professional decision making by the LMHP; (b) delays in evaluation and treatment could occur due to deficiencies or failures of the equipment; and (c) the possibility of disruption, distortion or unauthorized access during transmission of personal information due to internet/electronic/technical failures beyond the control of Pettable and my LMHP. 

By signing this form, I understand the following: 

1. I understand that Telehealth is the use of electronic communication technologies by a health and/or therapeutic provider to deliver services to an individual when he/she is located at a different site than the provider; and hereby consent to the LMHP to provide mental and social services to me via Telehealth. 
2. I understand that I may be required to have certain system requirements to access electronic Telehealth services via the method chosen. I understand that I am solely responsible for any cost to obtain  any additional/necessary system requirements, accessories, or software to use tele-behavioral health  services. 
3. I understand that I have the right to withhold or withdraw my consent to the use of Telehealth by  the LMHP at any time, without affecting my right to future care or treatment. 
4. I understand that a variety of alternative methods of health care may be available to me, and that I  may choose one or more of these at any time. 
5. I represent and warrant that all required information I provided to Pettable and the LMHP is truthful and accurate, and that I will maintain the accuracy of such information.
6. I understand that there are, by law, exceptions to confidentiality by a LMHP including, but not limited to, reporting child, elder and dependent adult abuse; expressed threats of violence toward an ascertainable victim; my own mental or emotional state informing a clear danger to myself or others; where I make my mental or emotional state an issue in a legal proceeding; where otherwise required by law.
7. I understand that I am solely responsible for the privacy and confidentiality in my surrounding environment while engaged in telehealth and will exercise appropriate privacy measures. 
8. I agree that if it becomes clear to the LMHP, in his or her sole professional opinion, that the  Telehealth modality is unable to provide all pertinent clinical information during the Telehealth encounter,  the LMHP will advise me prior to the conclusion of the live Telehealth encounter and will advise me  regarding the need for me to obtain an additional in-person evaluation reasonably able to meet my needs  and may make a referral to a LMHP in my area.
9. I understand that I have a duty to inform my LMHP of electronic interactions regarding my care  that I may have with other healthcare providers. 
10. I understand that Telehealth services may not be as complete as face-to-face services. 
11. I understand that there are potential risks and benefits associated with any form of treatment, and  despite my efforts and the efforts of my LMHP, my condition may not improve, and in some cases may  even get worse. 
12. I have been given an opportunity to select a LMHP prior to the consult, including a review of the consulting provider’s credentials.
13. I understand there is a risk of technical failures during the Telehealth encounter beyond the control of Pettable or my LMHP. I agree to hold harmless Pettable and my LHMP for delays in evaluation or for information lost due to such technical failures.
14. I understand that if I am experiencing a medical emergency or a crisis, that should dial 9-1-1 or contact the National Suicide Hotline 800-273-TALK (800-273-8255), as appropriate, immediately and that Pettable is not able to connect me directly to any local emergency services or crisis hotline.
15. I understand that Pettable does not guarantee that your LMHP will issue an Emotional Support Animal letter or that a landlord, airline , or other third party will accept your ESA Letter.  
16. I understand that my healthcare information may be shared with other individuals for scheduling and billing purposes.

I have read and understand the information provided above regarding teletherapy and all of my questions  have been answered to my satisfaction. By clicking the “I AGREE” button and typing my name at the  bottom of this page, I am authorizing the LMHP to whom Pettable facilitates a connection to assess my mental health via Telehealth and  confirming my agreement and understanding of the statements above. I hereby give my informed consent  and authorization for my LHMP to use Telehealth in my healthcare. 

I agree that a copy of this form may be treated as a signed original.