Informed Consent to Telehealth Treatment
FORMADYNE THERAPEUTICS PRIVATE LIMITED
Effective Date: April 1, 2026 | Last Updated: June 10, 2026 | Platform: formial.in
Part A — Your Consent Declarations
By proceeding with this, you consent to a telehealth consultation with Formial and authorize the collection and review of your health information, questionnaire responses, and photographs by licensed medical practitioners. You understand that this information will be used to assess your skin concerns, determine suitability for prescription skincare treatments, provide clinical recommendations, issue prescriptions where appropriate, and support ongoing treatment and follow-up care.
1. I understand that Formial provides telemedicine consultations and prescription skincare services, and that these are conducted remotely without a physical examination.
2. I understand that the Registered Practitioner assigned to me is an independent professional, and that Formial is not responsible for their clinical decisions. I will continue to maintain a relationship with my local primary care provider.
3. I acknowledge that my health information (including photographs, health history, and consultation notes) may be used for diagnosis, treatment planning, follow-up, and internal quality purposes.
4. I confirm that I have provided accurate and complete medical history, current medications, and allergy information, and I will promptly inform my Practitioner of any changes.
5. I have disclosed any pregnancy, breastfeeding status, or plans to conceive, and I understand that certain active ingredients may be contraindicated.
6. I understand that a prescription may not always be issued following a consultation — this is entirely the Practitioner's professional decision.
7. I understand that my personalised skincare formulation will contain prescription-only active ingredients and must be used strictly as directed. I am aware that results vary and that no specific cosmetic outcome is guaranteed.
8. I understand that Formial's telehealth services are NOT suitable for medical emergencies. In an emergency, I will call 112 or proceed to the nearest hospital immediately.
9. I have been informed of my rights as a patient, including my right to withdraw consent, refuse treatment, know my Practitioner's credentials, and access my medical records at any time.
10. I confirm that I am at least 18 years of age, or that I am a parent/guardian registering on behalf of a minor and accept full responsibility for their participation.
11. I confirm that I am currently located in India at the time of this consultation.
12. I acknowledge that transmission of health data over the internet carries inherent risks, and that Formial implements industry-standard security measures to protect my data.
13. I understand that Formial's total liability to me is limited to amounts paid in the three months preceding any claim, and that Formial is not liable for acts of independent practitioners or third-party services.
14. I confirm that I have read, understood, and agree to this Informed Consent Policy and all terms governing my use of Formial's Platform and services.
Part B — Governing Policy & Reference Information
The following sections constitute the full Informed Consent to Treatment via Telehealth and Governing Policy. Your agreement to Part A above confirms acceptance of all terms below.
1. About This Policy
FORMADYNE THERAPEUTICS PRIVATE LIMITED ("Formial", "we", "us", or "our") operates formial.in and the Formial mobile application (collectively, the "Platform"), providing telemedicine consultations, prescription skincare services, and ancillary health and wellness offerings.
This Policy explains how telemedicine consultations work on the Platform, what patients can expect from Formial's integrated compounding pharmacy model, the limitations of remote care, and the terms governing your use of these services.
This Policy should be read alongside our full Privacy Policy & Terms and Conditions available at formial.in/privacy-policy.
This Policy is published in compliance with:
- The Telemedicine Practice Guidelines, 2020 (National Medical Commission)
- The Drugs and Cosmetics Act, 1940 and Rules thereunder
- The Digital Personal Data Protection Act, 2023 (DPDPA 2023)
- The Information Technology Act, 2000 and IT (Amendment) Act, 2008
2. Nature of Telemedicine Service
Telehealth involves the use of electronic communications to enable healthcare providers to share individual patient medical information for the purpose of improving patient care. Formial is an integrated telemedicine and compounding pharmacy platform that connects patients with licensed doctors and, through Formial Pharmacy, formulates and dispenses personalized prescription skincare products.
Consultations conducted via the Platform constitute telemedicine services and are subject to the limitations inherent in remote assessment, including the absence of a physical examination.
Registered Practitioners empanelled with Formial are independent professionals. Formial is not vicariously liable for the medical advice, diagnosis, or treatment recommendations they provide. Formial Practitioners are an addition to, and not a replacement for, your local primary care provider.
The information you provide may be used for diagnosis, therapy, follow-up, and patient education, including health records and test results, images, asynchronous communications, live two-way audio and video, and two-way interactive audio with store-and-forward technology.
3. How Telehealth Consultations Work
3.1 Booking a Consultation
Patients register on the Platform, complete a health intake form, and book a telemedicine consultation with a Formial-empanelled Registered Practitioner. Consultations may be conducted via video, audio, or asynchronous (text/image) channels as available on the Platform.
3.2 What to Expect During a Consultation
- The Registered Practitioner will review your submitted health history, skin photographs, and any prior treatment information.
- A clinical assessment will be conducted remotely. You may be asked follow-up questions via the Platform's communication channel.
- If clinically appropriate, the Practitioner will issue a prescription for a personalised skincare formulation.
- You will receive a summary of the consultation and treatment plan through the Platform.
- Your assigned Practitioner will typically respond to follow-up messages within 12–24 hours via the Platform.
3.3 Your Responsibilities
- Provide accurate and complete medical history, current medications, and allergy information before and during the consultation.
- Disclose any pregnancy, breastfeeding, or plans to conceive prior to the consultation. Certain active ingredients are contraindicated in pregnancy.
- Inform your treating Practitioner of any changes in your health condition, medications, or adverse reactions promptly.
4. Expected Benefits of Telehealth
- Improved access to dermatological care by enabling you to consult from home without the need for a physical clinic visit.
- More efficient care evaluation and management, with consultations and follow-ups conducted through the Platform.
- Access to Formial-empanelled specialist Registered Practitioners who can issue prescriptions and monitor treatment progress remotely.
- Personalised prescription skincare formulations dispensed directly to your address, removing the need for separate pharmacy visits.
5. Service Limitations & Possible Risks
5.1 Service Limitations
The primary difference between telehealth and direct in-person care is the inability to conduct a physical examination. Some clinical needs may not be appropriate for a telehealth visit; your Registered Practitioner will make that determination. Alternatives to telehealth consultation, such as in-person services at a clinic or hospital, are always available to you.
Scope of Telehealth Services
The telehealth assessment, clinical guidance, and treatment recommendations provided through Formial are limited to the management of specific dermatological conditions, including but not limited to acne, post-acne pigmentation, hyperpigmentation, melasma, rosacea, photoaging, skin texture concerns, acne scarring, and other similar non-emergency dermatological conditions. Formial's services are not intended to diagnose or manage medical emergencies, severe systemic illnesses, rapidly progressing skin diseases, skin cancers, or conditions that require an in-person physical examination, laboratory testing, or specialist intervention. Where clinically appropriate, patients may be advised to seek in-person medical evaluation or referral to a relevant healthcare provider.
5.2 Possible Risks
- Delays in evaluation and treatment may occur due to deficiencies or failures of equipment, technology, or Practitioner availability.
- In some cases, the photos shared may not be clear enough for an accurate assessment. We may request additional photos, reschedule your consultation, or recommend an in-person consultation.
- In rare cases, security protocols could fail, causing a breach of privacy of personal medical information. Formial implements industry-standard security measures to mitigate this risk.
- In rare cases, a lack of access to complete medical records may result in adverse drug interactions, allergic reactions, or other clinical judgment errors. You are responsible for disclosing complete and accurate medical history.
6. Prescriptions
- Prescriptions issued via the Platform are valid only for conditions amenable to telemedicine diagnosis under applicable guidelines.
- Prescriptions for Schedule H, H1, and X drugs will only be issued where clinically appropriate and in compliance with the Drugs and Cosmetics Act, 1940 and Drugs and Cosmetics Rules, 1945. Habit-forming and Schedule X drugs are not processed.
- There is no guarantee that a prescription will be issued following a consultation; this decision rests entirely on the professional judgement of the Registered Practitioner. Formial does not influence or override the clinical judgment of its empanelled Practitioners.
7. Prescription Skincare — Formulation & Dispensation
Formial's core service includes the formulation, dispensation, and delivery of personalised prescription skincare products by Formial Pharmacy, a licensed compounding pharmacy operated by FORMADYNE THERAPEUTICS PRIVATE LIMITED. The following terms apply:
- Personalised skincare formulations are based on your consultation and are dispensed only against a valid prescription issued by a Formial-empanelled doctor.
- Formulations contain prescription-only active ingredients (e.g., tretinoin, hydroquinone, clindamycin) and must be used strictly as directed.
- For isotretinoin or other high-risk actives, additional consent, baseline investigations, and adherence to Formial's Isotretinoin SOP may be required before dispensation.
- Results vary between individuals. Formial does not guarantee specific cosmetic outcomes.
- Photograph submission for skin assessment constitutes your consent to the use of those images by Formial's team for diagnosis, treatment planning, and internal research and analytics only.
8. Emergency Care
⚠ IMPORTANT — Telehealth is Not for Emergencies
Telemedicine services are NOT suitable for medical emergencies. If you are experiencing a medical emergency, call 112 or proceed to the nearest hospital immediately.
Do not attempt to contact Formial or your Practitioner in an emergency. Formial bears no responsibility for outcomes arising from use of the Platform in emergency situations.
Examples of situations requiring immediate in-person care include (but are not limited to): severe allergic reactions, anaphylaxis, chest pain, difficulty breathing, loss of consciousness, or any condition where delay in treatment could result in serious harm. After receiving emergency treatment, you should visit your local primary care provider.
9. Your Rights as a Telehealth Patient
- Right to be informed: You have the right to be informed about the nature of the telehealth service, its limitations, and available alternatives including in-person care.
- Right to withdraw consent: You have the right to withdraw your consent to telehealth services at any time, without affecting your right to seek alternative or future care.
- Right to refuse: You retain the right to refuse a telehealth consultation at any time without penalty.
- Right to know your Practitioner: A licensed Registered Practitioner will be assigned to you prior to your consultation. You may request a different Practitioner at any time and are entitled to review their credentials.
- Right to privacy during consultation: If any other person is present during a real-time consultation (e.g., for technical support), you will be informed. You have the right to request that non-medical personnel leave the session or to terminate the consultation at any time.
- Right to medical records: You have the right to request a copy of your medical records and consultation summary, subject to applicable medical record-keeping regulations.
10. Eligibility for Telehealth Services
- You must be at least 18 years of age to independently access telehealth consultations. Minors may access services only with the express consent and supervision of a parent or legal guardian, who must register on the Platform on their behalf.
- You must be located in India at the time of the consultation.
- You warrant that all information provided during registration and intake is accurate, current, and complete.
11. Data Security & Technical Failures
Formial's electronic communication systems incorporate network and software security protocols including SSL/TLS encryption, encrypted storage for health data at rest, and role-based access controls to protect the confidentiality of patient identification and imaging data.
Notwithstanding these measures, no system is entirely immune to failure. You acknowledge and agree that:
- Transmission of personal medical information over the internet carries inherent risks.
- Health information may be shared internally for operational, quality assurance, scheduling, and billing purposes.
- Technical failures beyond Formial's control may result in delays in evaluation or loss of information. Formial's liability for such losses is limited to the extent permitted by applicable law.
- In the event of a data breach affecting your rights and interests, Formial will notify you as required under the DPDPA 2023.
You are responsible for maintaining the confidentiality of your account credentials and for ensuring your device and connection are reasonably secure. Report any suspected unauthorized access immediately to care@formial.in.
12. Medical Disclaimer
The information available on the Platform — including articles, blogs, product descriptions, and AI-generated suggestions — is for general informational and educational purposes only. It does not constitute medical advice and must not be used as a substitute for consultation with a qualified healthcare professional.
Formial does not guarantee the accuracy, completeness, or suitability of any health information on the Platform for any individual's specific medical condition. Always consult a Registered Practitioner before starting, changing, or stopping any treatment. No results from telehealth consultations or personalised formulations can be guaranteed or assured.
13. Limitation of Liability
To the maximum extent permitted by applicable law:
- Formial's total aggregate liability to you for any claims arising out of or in connection with the Platform shall not exceed the amount paid by you to Formial in the three (3) months immediately preceding the event giving rise to the claim.
- Formial shall not be liable for indirect, incidental, consequential, special, or punitive damages, including loss of data, loss of revenue, or medical complications arising from reliance on Platform content or services.
- Formial is not liable for acts or omissions of third-party service providers, independent medical practitioners, or pharmacies, except to the extent required by mandatory applicable law.
- Nothing in these Terms limits Formial's liability for death or personal injury caused by gross negligence or wilful misconduct, or for fraud.
14. Right to Decline or Discontinue Services
Formial is committed to providing safe, professional, and effective healthcare services. The provision of healthcare relies upon a therapeutic relationship founded on mutual trust, respect, open communication, and cooperation between patients, clinicians, and staff.
Formial reserves the right to decline, suspend, or discontinue services where there has been a breakdown of the therapeutic relationship, such that Formial reasonably determines that safe, effective, or appropriate care can no longer be provided. This may include circumstances where trust and confidence between the patient and Formial's clinicians or staff have deteriorated to a degree that adversely impacts the delivery of care.
Where reasonably practicable and clinically appropriate, patients will be notified of such a decision and advised to seek ongoing care from an alternative qualified healthcare provider. Any decision to decline or discontinue services will be made in accordance with applicable laws, professional standards, and patient safety considerations.
15. Patient Satisfaction, Treatment Outcomes and Refund Eligibility
Formial is committed to providing high-quality, evidence-based dermatological care and personalised prescription treatments. However, as with all medical treatments, individual responses and outcomes vary and cannot be guaranteed. A patient's dissatisfaction with their progress, perceived lack of improvement, or outcomes that differ from their personal expectations does not, by itself, constitute grounds for a refund.
Where a Money-Back Guarantee is offered, eligibility for a refund is determined solely by the specific terms and conditions of that guarantee. Patients who do not satisfy the eligibility criteria, treatment adherence requirements, review requirements, documentation requirements, or other stated conditions of the Money-Back Guarantee will not be entitled to an automatic refund.
In circumstances where a patient is dissatisfied with their treatment progress, Formial may, at its discretion, offer additional clinical review, treatment modification, or other reasonable support measures. Any refund request falling outside the published Money-Back Guarantee will be assessed on a case-by-case basis and remains at the sole discretion of Formial, subject to applicable law.
16. Governing Law & Dispute Resolution
- These Terms shall be governed by and construed in accordance with the laws of the Republic of India.
- In the event of any dispute or claim arising out of or relating to these Terms or the use of the Platform, the parties shall first attempt to resolve the matter through good-faith negotiation within 30 days of written notice.
- If unresolved, disputes shall be subject to binding arbitration under the Arbitration and Conciliation Act, 1996, with the seat of arbitration in Bengaluru, Karnataka. The arbitration shall be conducted in English before a sole arbitrator agreed upon by both parties.
- Nothing herein prevents either party from seeking urgent injunctive relief from competent courts in Bengaluru, Karnataka.
17. Grievance Redressal
In accordance with Formial's Grievance redressal policy and the Information Technology Act, 2000, the IT (Intermediary Guidelines and Digital Media Ethics Code) Rules, 2021, and the DPDPA 2023, Formial has appointed a Grievance Officer:
Grievance Officer: Dr Jeet Patel
Email: care@formial.in
Registered Address: No 181, K.B.A.R Road, Austin Town, Bengaluru, Karnataka, India
Response Time: Within 30 days of receipt of complaint
18. Contact Us
FORMADYNE THERAPEUTICS PRIVATE LIMITED
Website: formial.in
Email: admin@formial.in
Support: care@formial.in
Address: No 181, K.B.A.R Road, Austin Town, Bengaluru, Karnataka, India
FORMADYNE THERAPEUTICS PRIVATE LIMITED | formial.in | Bengaluru, India | care@formial.in