Terms of Use for Telemedical Treatment

§ 1. INTRODUCTION AND SCOPE

These Terms of Use govern the medical and technical aspects of telemedical treatment at Hormonexperten and supplement the General Terms and Conditions (GTC). By booking a video consultation, the patient accepts these terms.

§ 2. MEDICAL BASIS OF TREATMENT

§ 2.1 Focus of Treatment

Telemedical treatment at Hormonexperten focuses on:

§ 2.1.1 Bioidentical Hormone Therapy

• Individualized hormone replacement with bioidentical hormones
• Adjustment based on laboratory values and clinical symptoms
• Treatment of menopausal symptoms
• Hormonal balance after pregnancy
• Prevention of age-related hormone deficiencies

§ 2.1.2 Thyroid Consultation

• Diagnosis of thyroid dysfunction
• Optimization of thyroid medication
• Consultation regarding Hashimoto’s thyroiditis
• Holistic treatment approach

§ 2.2 Treatment Methodology

Treatment is provided in accordance with current scientific knowledge and combines conventional medical and complementary medical approaches. Therapy is tailored individually to each patient.

§ 2.3 Laboratory Diagnostics

• Comprehensive hormone analyses required
• Cooperation with certified laboratories
• Regular follow-up monitoring
• Interpretation and discussion of laboratory results

§ 3. PATIENT INFORMATION

§ 3.1 Bioidentical Hormone Therapy – Benefits and Risks

§ 3.1.1 Expected Benefits

• Relief of menopausal symptoms (hot flashes, sleep disturbances, mood swings)
• Improved quality of life
• Preservation of bone density
• Positive effects on skin and mucous membranes
• Stabilization of mental well-being
• Improvement of cognitive functions

§ 3.1.2 Possible Risks and Side Effects

Common (more than 10% of treated patients):

• Breast tenderness during the adjustment phase
• Breakthrough bleeding with estrogen therapy
• Mild weight fluctuations

Occasional (1–10% of treated patients):

• Headaches
• Nausea
• Fluid retention
• Mood fluctuations during the adjustment phase

Rare (less than 1% of treated patients):

• Allergic reactions to excipients
• Elevated liver enzymes
• Risk of thrombosis (lower than with synthetic hormones)

§ 3.1.3 Long-Term Risks

Although bioidentical hormones have a lower risk profile than synthetic hormones, a minimally increased risk of the following conditions cannot be completely excluded:

• Certain hormone-dependent tumors
• Thromboembolic events
• Gallbladder disease

Important: These risks are significantly lower than with synthetic hormone preparations and must be weighed against the risks of untreated hormone deficiency.

§ 3.2 Contraindications

§ 3.2.1 Absolute Contraindications

Hormone therapy must NOT be performed in cases of:

• Existing or suspected hormone-dependent tumors (breast, uterus)
• Unexplained vaginal bleeding
• Acute thromboembolic disease
• Acute liver disease
• Porphyria
• Known hypersensitivity to active ingredients

§ 3.2.2 Relative Contraindications

Particularly careful risk-benefit assessment is required in cases of:

• History of thrombosis
• Family history of breast cancer
• Endometriosis
• Migraine
• Epilepsy
• Diabetes mellitus
• Hypertension

§ 3.3 Drug Interactions

Bioidentical hormones may interact with:

• Anticoagulants
• Antiepileptic drugs
• Antibiotics, especially rifampicin
• St. John’s wort
• Certain antidepressants
• Certain thyroid hormones

§ 3.4 Monitoring and Follow-Up

§ 3.4.1 Before Initiation of Therapy

• Detailed medical history
• Current gynecological or urological examination, not older than 12 months
• Baseline laboratory values
• Blood pressure measurement
• Mammography or ultrasound if indicated

§ 3.4.2 During Therapy

• Follow-up after 3 months
• Thereafter every 6 to 12 months
• Regular laboratory monitoring
• Dose adjustment as needed

§ 3.4.3 Criteria for Discontinuation

Therapy must be stopped immediately in the event of:

• Occurrence of contraindications
• Severe side effects
• Suspected thromboembolic events
• Unexplained bleeding
• Jaundice or worsening liver values
• Significant increase in blood pressure
• Pregnancy

§ 4. PATIENT OBLIGATIONS AND COOPERATION

§ 4.1 Duty to Provide Information

The patient undertakes to:

• Provide complete and truthful information regarding medical history
• Inform about all medications and dietary supplements taken
• Report allergies and intolerances
• Inform immediately of any side effects
• Inform about pregnancy or intention to become pregnant

§ 4.2 Follow-Up Examinations

§ 4.2.1 Annual Mandatory Examinations

The patient undertakes to undergo annually:

• Gynecological or urological check-ups
• Breast cancer screening from the age of 40
• Submission of findings by email to info@hormonexperten.de

§ 4.2.2 Documentation

If necessary, the patient shall keep a symptom diary for monitoring purposes.

§ 4.3 Adherence to Therapy (Compliance)

• Take medication as prescribed
• No independent dose adjustments
• Regular intake for optimal effect
• Inform the physician in case of intake problems

§ 4.4 Lifestyle Measures

For optimal therapy results, the following are recommended:

• Healthy diet
• Regular physical activity
• Stress reduction
• Adequate sleep
• Avoidance of nicotine
• Moderate alcohol consumption

§ 5. TECHNICAL CONDUCT OF THE VIDEO CONSULTATION

§ 5.1 Appointment Preparation

§ 5.1.1 Technical Preparation

• Test camera and microphone
• Check stable internet connection
• Update browser
• Have the Whereby link ready

§ 5.1.2 Medical Preparation

• Have current laboratory values available
• Prepare medication list
• Note symptoms
• Prepare questions

§ 5.1.3 Environment Preparation

• Quiet, private room
• Good lighting
• No disturbances during consultation
• Ensure confidentiality

§ 5.2 Procedure of the Video Consultation

• Log in 5 minutes before the appointment
• Open the Whereby link
• Enable camera and microphone
• Wait in the waiting room
• Greeting and identification
• Identity verification by the physician
• Technical connection check
• Consultation including medical history and discussion
• Review of findings
• Therapy planning
• Documentation
• Summary of the discussion
• Prescription issuance if required
• Scheduling of follow-up appointment

§ 5.3 Punctuality and Waiting Times

• Log in 5 minutes before the appointment
• Maximum waiting time for the physician: 5 minutes in case of delay
• In case of technical problems: contact by telephone

§ 5.4 Technical Disruptions

In case of technical disruptions:

1. Restart the browser
2. Check internet connection
3. Try an alternative browser
4. Establish telephone contact
5. Arrange a replacement appointment

§ 6. COMMUNICATION RULES

§ 6.1 Email Communication

§ 6.1.1 Free Communication

• Initial inquiry to assess suitability
• Appointment scheduling
• Submission of laboratory values
• Administrative questions

§ 6.1.2 Paid Medical Email Consultation

• Medical questions between appointments
• Dose adjustments
• Interpretation of findings
• Second opinions

§ 6.2 Premium-Queen Communication

For Premium-Queen clients:

• Email or SMS response within 48 hours
• Response time applies to business days, Monday to Friday
• Weekends and public holidays excluded
• Prioritized processing

§ 6.3 Emergencies

IMPORTANT: This practice does NOT provide emergency care.

In case of medical emergencies:

• Contact local emergency services immediately
• Emergency number 112, throughout the EU
• Visit the nearest emergency department
• Contact your general practitioner or out-of-hours medical service

§ 6.4 Communication Standards

• Respectful tone
• Objective description of complaints
• No insulting or aggressive messages
• Confidential handling of information

§ 7. PRESCRIPTIONS AND MEDICATION SUPPLY

§ 7.1 Issuance of Prescriptions

• After medical review and indication
• Issued as a private prescription
• Sent by email, PDF, or by post
• Validity according to local pharmacy regulations

§ 7.2 Hormone Preparations

• Individual formulations prepared by pharmacies
• Costs approximately €1.00 to €1.50 per day
• Supply through specialized pharmacies
• List of recommended pharmacies available upon request

§ 7.3 Prescription Fees

• Up to 2 products: €15
• From 3 products: €30
• Partially included in package bookings

§ 7.4 Repeat Prescriptions

• Request in good time, at least 1 week before depletion
• For Premium-Queen: 6 months included
• Requirement: Current follow-up values

§ 8. QUALITY ASSURANCE

§ 8.1 Medical Standards

• Treatment according to current scientific standards
• Regular continuing education of the physician
• Evidence-based medicine
• Individualized therapy concepts

§ 8.2 Documentation

• Complete treatment documentation
• Secure data storage
• Retention period of 10 years
• Right of access for patients

§ 8.3 Feedback and Complaints

• Feedback welcomed for quality improvement
• Complaints to: info@hormonexperten.de within 14 days
• Review and constructive resolution

§ 9. SPECIAL NOTICES

§ 9.1 Pregnancy and Breastfeeding

• Hormone therapy must be discontinued immediately in case of pregnancy
• During breastfeeding only after consultation
• Contraception to be discussed during fertile years

§ 9.2 Travel

• Bring sufficient medication
• Medical certificate for customs if required
• Consider time zone changes when taking medication
• Observe storage conditions

§ 9.3 Surgical Procedures

• Discuss hormone therapy with the surgeon before planned operations
• Temporary discontinuation may be required
• Inform the anesthesiologist

§ 9.4 Change to Other Physicians

• Digital medical record provided upon written request and signature
• Record includes diagnoses, treatment history and laboratory values
• Medical concepts, personal notes and therapeutic know-how are excluded and will not be disclosed
• Laboratory values are additionally available digitally from the respective laboratory
• Observe transition period for medication supply
• Final consultation recommended

§ 10. LIMITATIONS OF TELEMEDICINE

§ 10.1 Services Not Possible via Video Consultation

The following services cannot be provided via video consultation:

• Physical examinations
• Ultrasound examinations
• Blood sampling
• Injections
• Acute care

§ 10.2 Referral to In-Person Care

If necessary, the physician refers to:

• Local specialists
• Diagnostic centers
• Emergency facilities
• Specialized laboratories

§ 10.3 Cooperation with Other Physicians

• Exchange of findings with consent
• Interdisciplinary collaboration
• Respect for second opinions

§ 11. DATA PROTECTION AND CONFIDENTIALITY

§ 11.1 Medical Confidentiality

All staff are subject to medical confidentiality. Information will only be disclosed with:

• Express consent
• Legal obligation
• Vital indication

§ 11.2 Data Security

• Encrypted data transmission
• Secure server locations
• Regular security updates
• Access control

§ 11.3 Medical Records

• Maintained digitally
• Complete documentation
• Right of access guaranteed
• Copies upon request

§ 12. TERMINATION OF TREATMENT

§ 12.1 By the Patient

• At any time without stating reasons
• Written notice recommended
• Transfer of records
• Final prescription if required

§ 12.2 By the Physician

Termination possible in case of:

• Loss of trust
• Patient non-compliance
• Aggressive or insulting communication
• Payment default
• Medical reasons

§ 12.3 Transitional Arrangement

• 4-week transition period for medication supply
• Assistance in finding a new physician
• Transfer of medical records

§ 13. SCIENTIFIC BACKGROUND

§ 13.1 Evidence-Based Medicine

Treatment is based on:

• European medical guidelines
• Peer-reviewed studies
• International consensus papers
• Clinical experience

§ 13.2 Continuing Education

• Regular participation in professional congresses
• Continuous medical education
• Exchange with professional colleagues
• Integration of new findings

§ 13.3 Participation in Studies

• Information about relevant studies
• Voluntary participation possible
• Separate consent required
• No disadvantages in case of refusal

§ 14. FINAL PROVISIONS

§ 14.1 Supplement to the GTC

These Terms of Use supplement the General Terms and Conditions and apply in conjunction with them.

§ 14.2 Updates

The Terms of Use are regularly updated and adapted to the current state of medical science.

§ 14.3 Consent

By booking a video consultation, the patient confirms:

• Having read and understood these Terms of Use
• Agreeing to the described treatment methodology
• Accepting the limitations of telemedical treatment
• Fulfilling the patient obligations

§ 14.4 Questions and Clarifications

For questions or uncertainties regarding these Terms of Use, please contact:

Email: info@hormonexperten.de
Phone: +49 1512 2682 778

APPENDIX: IMPORTANT INFORMATION AT A GLANCE

Checklist Before the First Appointment

[ ] Current laboratory values, not older than 3 months
[ ] Gynecological or urological findings, not older than 12 months
[ ] Medication list
[ ] Allergy card, if available
[ ] Previous findings, if available
[ ] Health insurance card, for information purposes only, no billing possible

Emergency Contacts

Europe-wide emergency number: 112
On-call medical service Germany: 116 117
Poison control: Request local number

Recommended Monitoring Intervals

Initial adjustment: After 3 months
Stable adjustment: Every 6 to 12 months
Laboratory monitoring: Every 3 to 6 months
Gynecological examination: Annually
Mammography: From age 40 every 2 years