Terms & Conditions
Silence Medical, PLLC | Effective: April 28, 2026
These Terms & Conditions ("Terms") govern your use of the website operated by Silence Medical, PLLC at silencemed.com (the "Site") and the telehealth services provided through it (the "Services"). By using the Site or receiving Services, you agree to these Terms. If you do not agree, do not use the Site or Services.
1. About Silence Medical
Silence Medical is a direct-pay telehealth practice. Clinical services are provided by Alexis Silence, FNP-C, a Family Nurse Practitioner licensed in Arizona and Colorado. Services are limited to patients physically located in Arizona or Colorado at the time of the visit. We do not provide services to patients located in any other state.
2. Scope of Services
Silence Medical provides metabolic and weight-management telehealth consultations and prescribes non-controlled medications when clinically appropriate. Silence Medical does not provide:
primary care services or routine preventive care;
emergency or urgent medical services;
management of chronic conditions outside the scope of metabolic care;
controlled-substance prescriptions; or
services to patients located outside Arizona or Colorado at the time of the visit.
You are responsible for maintaining a relationship with a separate primary care provider. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room.
3. Eligibility
To use the Services, you must (a) be at least 18 years of age; (b) be physically located in Arizona or Colorado at the time of each visit; (c) provide complete and accurate medical history and personal information; and (d) have the legal capacity to enter into these Terms. By using the Services, you represent that each of these conditions is satisfied.
4. Telehealth
Services are provided by telehealth, including secure video, audio, and asynchronous electronic communication. You acknowledge that telehealth has limitations, that information may occasionally be lost due to technical failures, and that your provider may determine that telehealth is not appropriate for your condition and recommend in-person care. Confidentiality, security, and licensure standards applicable to in-person healthcare apply to telehealth visits.
You consent to the electronic transmission of your health information as part of the Services. You may withdraw consent to telehealth at any time by notifying us in writing.
5. Provider-Patient Relationship
Use of the Site does not create a provider-patient relationship. A provider-patient relationship is established only after Silence Medical has accepted you as a patient and you have completed an initial visit.
6. Payment, Pricing, and Refunds
Silence Medical is direct-pay. We do not bill insurance. Each visit results in a single, comprehensive charge that includes the consultation, any prescribed medication, supplies, shipping, and ongoing care management. ACH and card payments are accepted. Pricing is disclosed before any charge is authorized. Our Refund & Cancellation Policy, available at silencemed.com, is incorporated into these Terms by reference and governs cancellations, refunds, and shipping issues.
7. Patient Responsibilities
You agree to (a) provide accurate and complete medical, identity, and contact information; (b) follow your provider’s clinical recommendations or notify your provider if you do not intend to follow them; (c) report adverse events or side effects promptly; (d) complete recommended laboratory testing when ordered; and (e) not share medications prescribed to you with any other person.
8. Prescriptions and Pharmacy
Prescriptions, when issued, are transmitted to our partner pharmacy, an FDA-registered 503A outsourcing facility, which dispenses and ships medications directly to you. We do not stock, dispense, or ship medications ourselves. Once dispensed, medications cannot be returned or refunded as set forth in the Refund & Cancellation Policy. Written prescriptions for fulfillment by an outside pharmacy of your choosing are available on request.
9. Communications
By providing your phone number or email, you authorize Silence Medical to contact you at that number or email regarding appointments, treatment, payment, and patient-care matters, including by automated text message or voice call. Standard message and data rates may apply. You may opt out of non-essential communications by replying STOP to any text message or by contacting us. Certain treatment, payment, and healthcare-operations communications may continue as permitted by HIPAA.
10. Privacy
Your use of the Site and Services is also governed by our Privacy Policy and our Notice of Privacy Practices, both available at silencemed.com. The Notice of Privacy Practices describes how we use and disclose protected health information under HIPAA and explains your rights with respect to that information.
11. Intellectual Property
All content on the Site, including text, graphics, logos, and trademarks, is owned by Silence Medical or its licensors and is protected by copyright and trademark law. You may not copy, reproduce, or use Site content for any commercial purpose without prior written permission.
12. Disclaimers
The Services are provided on an "as is" and "as available" basis. Silence Medical makes no guarantee as to medical outcome, cure, or specific results. To the maximum extent permitted by law, Silence Medical disclaims all warranties, express or implied, including warranties of merchantability, fitness for a particular purpose, and non-infringement, except for any non-disclaimable warranties imposed by law.
13. Limitation of Liability
To the maximum extent permitted by law, Silence Medical and its owners, employees, and contractors will not be liable for any indirect, incidental, consequential, special, or punitive damages arising from or related to your use of the Site or Services. Nothing in this section limits liability for professional negligence, gross negligence, or willful misconduct, or any other liability that cannot be limited under applicable law.
14. Indemnification
You agree to indemnify and hold harmless Silence Medical from any claim, loss, or expense arising from (a) your breach of these Terms; (b) your provision of inaccurate medical, identity, or insurance information; or (c) your use of medications contrary to your provider’s instructions.
15. Governing Law and Venue
These Terms are governed by the laws of the State of Arizona without regard to its conflict-of-laws rules. Subject to Section 16, any dispute arising from these Terms, the Site, or the Services that is not resolved by arbitration will be brought exclusively in the state or federal courts located in Maricopa County, Arizona, and you consent to the personal jurisdiction of those courts.
16. Dispute Resolution — Informal Resolution and Arbitration
Before initiating any formal proceeding, you agree to contact Silence Medical and attempt to resolve the dispute informally for at least thirty (30) days. If the dispute is not resolved, except for claims that may be brought in small-claims court and except for claims of professional malpractice or for injunctive relief, any dispute arising from these Terms or the Services will be resolved by binding individual arbitration administered by the American Arbitration Association under its Consumer Arbitration Rules. Arbitration will be held in Maricopa County, Arizona, or by remote means at the arbitrator’s discretion.
Class-action waiver. You and Silence Medical agree that any arbitration or proceeding will be conducted on an individual basis only and not as a class, collective, or representative action. If a court determines that this waiver is unenforceable as to a particular claim, that claim must proceed in court and is severed from arbitration; the remaining claims must still be arbitrated.
Nothing in this section prohibits you from filing a complaint with the Arizona State Board of Nursing, the Colorado State Board of Nursing, the U.S. Department of Health and Human Services Office for Civil Rights, or any other regulatory body with jurisdiction.
17. Changes to These Terms
We may update these Terms from time to time. The version in effect on the date you use the Services governs that use. Material changes will be posted at silencemed.com with an updated effective date. Your continued use of the Site or Services after the effective date constitutes acceptance of the updated Terms.
18. Contact
Silence Medical, PLLC
Email: alexis@silencemed.com
Phone: (602) 931-2469
Mailing: 20235 N. Cave Creek Rd., Ste. 104 #460, Phoenix, AZ 85024