Consent Agreement

Last Updated: April 25, 2026

Consent to Treat

I authorize the medical staff, other personnel, and such associates, assistants, and other health care providers of Pairtu, Inc. ("Dearest Care"), Pairtu Health Medical Group PA, Pairtu Medical Group of California PC, and Pairtu Health Medical Group East PC, to provide care, including telehealth or other services, as their staff finds necessary or advisable in my care. If I am making this authorization on behalf of another person, I acknowledge that I am consenting on behalf of the patient and I am authorized to do so.

Consent to Health Records Requests

I authorize the medical staff, other personnel, and such associates, assistants, and other health care providers of Pairtu, Inc. and its aformentioned practices to request, receive, and use my medical records as Pairtu, Inc. dba “Dearest Care”, Pairtu Health Medical Group PA, Pairtu Health Medical Group of California PC and Pairtu Health Medical Group East PC, staff finds necessary or advisable in my care. If I am making this authorization on behalf of another person, I acknowledge that I am consenting on behalf of the patient and I am authorized to do so.

Digital Copy

I agree a digital copy of this agreement shall be valid as the original.