Care2Talk Health

Terms of Service and Policy

We are committed to maintaining the accuracy, confidentiality, and security of your personally identifiable information ("Personal Information"). As part of this commitment, our privacy policy governs our actions as they relate to the collection, use and disclosure of Personal Information. Our privacy policy is based upon the values set by the Canadian Standards Association's Model Code for the Protection of Personal Information and Canada's Personal Information Protection and Electronic Documents Act.

1. Introduction

We are responsible for maintaining and protecting the Personal Information under our control. We have designated an individual or individuals who is/are responsible for compliance with our privacy policy.

2. Identifying Purposes

We collect, use and disclose Personal Information to provide you with the product or service you have requested and to offer you additional products and services we believe you might be interested in. The purposes for which we collect Personal Information will be identified before or at the time we collect the information. In certain circumstances, the purposes for which information is collected may be clear, and consent may be implied, such as where your name, address and payment information is provided as part of the order process.

3. Consent

Knowledge and consent are required for the collection, use or disclosure of Personal Information except where required or permitted by law. Providing us with your Personal Information is always your choice. However, your decision not to provide certain information may limit our ability to provide you with our products or services. We will not require you to consent to the collection, use, or disclosure of information as a condition to the supply of a product or service, except as required to be able to supply the product or service.

4. Limiting Collection

The Personal Information collected will be limited to those details necessary for the purposes identified by us. With your consent, we may collect Personal Information from you in person, over the telephone or by corresponding with you via mail, facsimile, or the Internet.

5. Limiting Use, Disclosure and Retention

Personal Information may only be used or disclosed for the purpose for which it was collected unless you have otherwise consented, or when it is required or permitted by law. Personal Information will only be retained for the period of time required to fulfill the purpose for which we collected it or as may be required by law.

6. Accuracy

Personal Information will be maintained in as accurate, complete and up-to-date form as is necessary to fulfill the purposes for which it is to be used.

7. Safeguarding Customer Information

Personal Information will be protected by security safeguards that are appropriate to the sensitivity level of the information. We take all reasonable precautions to protect your Personal Information from any loss or unauthorized use, access or disclosure.

8. Openness

We will make information available to you about our policies and practices with respect to the management of your Personal Information.

9. Customer Access

Upon request, you will be informed of the existence, use and disclosure of your Personal Information, and will be given access to it. You may verify the accuracy and completeness of your Personal Information, and may request that it be amended, if appropriate. However, in certain circumstances permitted by law, we will not disclose certain information to you. For example, we may not disclose information relating to you if other individuals are referenced or if there are legal, security or commercial proprietary restrictions.

10. Refund and Cancellation Policy

If you're on an annual plan, you are contractually committed to the annual term as you save 20%.

If you decide to cancel your annual plan early, you may transfer it to another individual at no addional cost.

If you're on a month-to-month plan, we require 30 days' notice before your renewal date to ensure a smooth transfer of your health records and history. This allows us to account for any incoming information from other clinics, such as referrals and/or blood work results.

Once paid and enrolled in a plan, the sale is final as we begin the onboarding process to ensure you are matched with the most suitable team.

For downgrading plans, we require 30 days' notice before your renewal date to ensure a smooth transfer.

To request a cancellation, please email our support team at support@care2talk.io.

All one-time appointments are conducted virtually and are final sales. Please note that we do not offer free consultations or document reviews before payment.

If you're unsure which plan is right for you, feel free to call us at 778-404-7725 or email support@care2talk.io. We're happy to help!

Please note that not all forms can be completed virtually. Some may require an in-person visit.

*Signing up for private care means you'll receive dedicated support, but some healthcare appointments may still be subject to limitations. Our team follows Health Canada’s guidelines to ensure safe and high-quality care.

11. In - person Appontment times ( Plus users )

As a valued Plus user, you will have access to two to three in-person appointment time options each week in Victoria. Qualicum Beach, will be offering five days a week. Please note that these time slots may be subject to change due to unforeseen circumstances.

Our team is committed to providing you with the highest quality of care and maintaining optimal scheduling. While we will make every effort to honor your selected time, we appreciate your understanding as we work to deliver the gold standard of service.

* In -person appointment times, 30 minutes. (please allow sometime to chart)

** Our clinic(s) may have certain limitations due to available supplies or equipment, but we will make every effort to accommodate your appointment needs.

*** Signing up for private care means you'll receive dedicated support, but some healthcare appointments may still be subject to limitations. Our team follows Health Canada’s guidelines to ensure safe and high-quality care.

12. Controlled Substances via Telehealth

Prescription of controlled medications including opioids (codeine, oxycodone, oxycontin, hydromorphone etc.), benzodiazepines (lorazepam, clonazepam etc.) and sleeping medications (zopiclone etc.) are coming under increased scrutiny and regulation by the College of Physicians and Surgeons of British Columbia (CPSBC) due to the tragic spike in overdose deaths relating to these medications over the past year in British Columbia.

All providers practicing in British Columbia are bound by this Standard which ‘reflects relevant legal requirements and are enforceable under the Health Professions Act, RSBC 1996, c.183 (HPA) and College Bylaws under the HPA.

Refills for these medications must be made in person with your provider as a reassessment of your pain and function is required on a regular basis (unless these medications are prescribed in the context of palliative care or cancer management). If you have any questions relating to changes in your medications or the new clinic policies please book an appointment to speak with your provider.

In British Columbia, Nurse Practitioners (NPs) are authorized to prescribe controlled substances, including sedatives like zopiclone, through telehealth under specific guidelines. To ensure safe prescribing practices, the following conditions must be met:

1. Established Therapeutic Relationship: NPs must have an ongoing, established therapeutic relationship with the patient, having previously assessed their medical and medication history.
2. Appropriate Assessment: NPs will conduct comprehensive evaluations via video consultations to assess the patient's medical history, current condition, and risks, including screening for mental health conditions and substance misuse.
3. Informed Consent: Prior to prescribing, patients must provide informed consent for both the prescribed medication and telehealth services, understanding potential risks and alternatives.
4. Risk Management & Monitoring: NPs will assess the risk of substance misuse, screen for mental health issues, and monitor ongoing use through follow-up appointments to ensure safe and effective treatment.
5. Documentation: All consultations, including assessments and informed consent, will be thoroughly documented, and prescriptions will be tracked according to regulatory requirements.
6. Prescription Limits: NPs will prescribe the minimum effective dose for the shortest necessary duration and follow all relevant regulations on controlled substances.
7. Right to Decline Prescription: NPs have the right to refuse prescribing controlled substances if there is insufficient information or if they believe the prescription may not be in the patient's best interest.

By using our telehealth services, patients acknowledge these guidelines and consent to receiving care in accordance with them.

13. Guidelines for ADHD Telemedicine patients:

1. Severe ADHD Symptoms: (We can offer a diagnosis but no follow up care unless enrolled in one of our plans)

a. Clients with severe ADHD symptoms with Comorbidities that require immediate and intensive intervention are not appropriate for virtual care. In such cases, in-person consultations are recommended (ie. Legal involvement or failure to respond to previous outpatient treatment and medication management)

2. High Risk of Self Harm or Suicide:

a. Clients who present as high risk of self-harm or suicide are excluded from virtual care. This includes active suicidal ideation or clients at high risk (CAMH provides a good resource for suicide risk assessment here). Immediate in-person assessment and intervention are necessary in these situations.

b. Clients expressing interest in seeking MAID for mental disorders are also not appropriate for virtual care. The heightened risk warrants a comprehensive in-person approach to thoroughly address the complex mental health concerns associated with MAID requests and provide intervention that is beyond the scope
of virtual care.

3. Complex Psychiatric Conditions:

a. Clients with complex psychiatric conditions requiring a higher level of care or frequent in-person assessments will be excluded.

b. This includes: history of psychosis, schizophrenia, bipolar disorder, active
anorexia, and severe depression or anxiety.

4. Cardiac Conditions:

a. Medications used to treat ADHD, including psychostimulants, Atomoxetine, and Bupropion can all increase blood pressure and heart rate. The stimulatory effects from these drugs on the sympathetic nervous system are usually mild, but in patients with cardiovascular compromise, these effects may result in serious
adverse events including sudden/cardiac death.

b. Clients with pre-existing cardiovascular issues (e.g. heart disease, arrhythmias, or structural heart abnormalities) should have a cardiac consult to determine whether ADHD medications are appropriate. These clients are not appropriate for virtual care due to our reliance on client’s self-monitoring their BP/HR. They should be managed in-person to ensure close monitoring of their BP and cardiac conditionc. Clients with unstable hypertension require stabilization before initiating prescribing. Once stabilised, they must have a PCP to manage their BP issues before they can be treated for ADHD virtually due to our reliance on client’s self-monitoring their BP/HR. We also require a letter on file from the client’s PCP or WIC confirming their BP is stable, that the provider assumes ongoing responsibility for monitoring and managing their BP issues, and that they will notify us if there is a change in their cardiac health history. We reserve the right to discontinue treatment at any time.

5. Age:

a. For clients aged 65 years and older, in-person management is recommended due to an elevated risk of developing cardiovascular conditions. In-person visits allow healthcare providers to conduct routine cardiac exams and closely monitor blood pressure, which cannot be adequately achieved through virtual care. In virtual settings, we rely on patients to self-monitor their blood pressure and report the results to us, which may not provide the same level of comprehensive
cardiovascular assessment as in-person examinations.

6. Pheochromocytoma:

a. Caution is advised with the use of psychostimulants due to their potential to further increase catecholamine levels and exacerbate symptoms. Close
monitoring of blood pressure and cardiovascular function is typically
recommended if stimulant medications are considered so these patients are best managed in-person.

7. Pregnancy and Lactation:

a. The available evidence surrounding methylphenidate, dextroamphetamine, and Adderall XR use in pregnancy and breastfeeding is included in the NP Guide, along with links to Mother to Baby Factsheets that can be provided to women. Given that pregnancy is a higher risk population, it would be safer for these patients to be managed in-person if they choose to continue their medications. Women can return to the program to resume treatment once they have finished breastfeeding and or have conducted their own assessment and provide consent for therapy.

8. Serious Neurological Conditions or Brain Injuries:

a. These conditions can impact cognitive function, behaviour, and the central

nervous system in complex ways that necessitate close monitoring and
potentially frequent adjustments in treatment. Additionally, the risk of medication interactions and side effects may be heightened, requiring careful in-person assessment and management. Given these complexities, prescribing for ADHD in the context of significant neurological conditions or brain injuries is best conducted within an in-person healthcare setting where thorough evaluations and immediate interventions are more readily available.

b. This includes: Epilepsy, MS, Parkinson’s Disease, Alzheimer’s Disease and other dementias, TBI with residual effects, Stroke, ALS, brain tumours,
spinal cord injuries, and neuromuscular disorders (e.g. muscular dystrophy
and myasthenia gravis).

9. Limited Therapeutic Relationship:

a. Clients who, based on a clinical assessment, may struggle to establish and maintain a therapeutic relationship through virtual means will not be eligible.

EXCLUSION CRITERIA FOR PSYCHOSTIMULANTS AND ATOMOXETINE

1. Cardiac History
a. Clients with serious cardiac conditions, such as recent myocardial infarction, serious arrhythmia, advanced arteriosclerosis, symptomatic cardiovascular disease, or uncontrolled hypertension, are not candidates for either psychostimulants, atomoxetine, or bupropion.

2. Psychosis
a. Clients with a history of psychosis or a psychotic disorder are excluded from psychostimulant therapy due to potential exacerbation of psychiatric symptoms.

3. Glaucoma
a. Clients with glaucoma are excluded from psychostimulant therapy due to the potential increase in intraocular pressure.
b. Clients with narrow-angle glaucoma are not appropriate for treatment with atomoxetine.

4. Untreated Hyperthyroidism
a. Clients with untreated hyperthyroidism are not eligible for psychostimulants or atomoxetine, as they can exacerbate symptoms.

5. Severe Anxiety or Agitation
a. Clients with severe anxiety or agitation are not suitable candidates for
psychostimulant therapy, as it may worsen these symptoms. Caution is also
advised with the use of Wellbutrin in this population, as this can also worsen
anxiety. Atomoxetine may be a reasonable option to consider in this population.

6. MAOI Therapy
a. Clients currently taking monoamine oxidase inhibitors (MAOIs) are excluded from psychostimulant therapy or atomoxetine due to potential drug interactions. Clients must have stopped their MAOI at least 14 days prior to psychostimulant initiation.

7. Pheochromocytoma
a. Clients with pheochromocytoma are not appropriate for Atomoxetine.

8. Allergy or Hypersensitivity
a. Clients with a known allergy or hypersensitivity to the psychostimulants or Atomoxetine.

This policy is designed to ensure the safety and well-being of our clients, providing the most appropriate care based on individual needs and circumstances. Additionally, this policy serves to protect our healthcare providers by addressing liability risks associated with virtual care. This
policy is subject to periodic review and updates as needed.

14. Respectful Conduct

At Care2Talk Health, we are committed to providing a safe and respectful environment for our staff and patients. We do not tolerate verbal abuse, loud or disruptive behavior, or any form of threats directed at our team members. Any such conduct may result in the termination of services and, if necessary, further action.

We reserve the right to refuse service to individuals who engage in aggressive or inappropriate behavior. Ensuring a safe and positive experience for all is our priority.

By using our services, you agree to uphold this standard of respect and professionalism.

14. Handling Support, Customer Complaints, and Suggestions

You may direct any questions or enquiries with respect to our privacy policy or our practices by contacting: support@care2talk.io

15. Hours of Operations

Monday to Friday - 7am to 4pm (Times May Vary)

Sunday - Closed

Holidays - Closed

16. Regions We Operate In

We provide healthcare services across Western Canada, including British Columbia through to Ontario, Canada.
Please note that patients must be physically located within one of these provinces to access our care. Unfortunately, we are unable to offer healthcare services outside of Canada, even to Canadian residents.