Terms of Service

Last Revised: December 31, 2025

These Terms of Service ("Terms") govern your access to and use of the services provided by Pascal (dba Roundtable Diagnostics, LLC) ("Pascal", "we", "us", or "our") through the Pascal websites located at https://textpascal.com and other related websites, web-based applications, mobile applications (including the Spruce Health mobile application), and messaging services (collectively, the "Site"), as well as services provided by our affiliated medical practice ("Pascal Medical") that include personal healthcare services (the "Services").

Please read these Terms carefully before using the Site or the Services. By accessing or using the Site you agree to be bound by these Terms. If you do not agree to these Terms, please do not use the Site or our Services.

Please note that these Terms contain provisions that govern the resolution of claims between us and you, including an arbitration agreement, class action waiver, and jury trial waiver that affect your rights. In arbitration, there is no judge or jury and there is less discovery and appellate review than in court.

Healthcare Services

Pascal (dba Roundtable Diagnostics, LLC) provides only administrative and technology services to support our affiliated medical practice. Pascal does not practice medicine, employ physicians, make clinical decisions, or provide medical advice. Pascal does not interfere with the practice of medicine or any other licensed profession by Pascal Medical or other third parties.

Pascal Medical is an independent affiliated medical practice that operates under applicable laws of the states in which it provides healthcare and related services. Pascal Medical provides all clinical and healthcare services, including telehealth services related to cardiovascular and metabolic health. All medical decisions are made solely by the licensed healthcare providers of Pascal Medical.

You agree that these Terms govern your access to and use of the Site and the Services offered by Pascal and Pascal Medical. Please refer to our Privacy Policy and Health Information Privacy Policy to learn how we use, share, and protect your protected health information.

Telehealth Services and Informed Consent

Pascal Medical provides telehealth services primarily through text-based (asynchronous) communication. By using our Services, you acknowledge and agree to the following:

Nature of Text-Based Telehealth

Our Services are delivered primarily through text messaging and asynchronous communication. This means you may not receive immediate responses, and clinical assessments are conducted without the benefit of a physical examination.

Limitations of Text-Based Care

You understand and acknowledge that:

  • Text-based communication has inherent limitations for medical diagnosis
  • Your provider cannot perform a physical examination
  • Some conditions cannot be adequately assessed or treated via text alone
  • Certain clinical situations may require audio or video consultation, which you agree to participate in when clinically indicated
  • In some cases, in-person care may be necessary and will be recommended

Conditions NOT Appropriate for Text-Based Care

Our text-based Services are NOT appropriate for medical emergencies or urgent conditions. If you experience any of the following, call 911 or go to your nearest emergency room immediately:

  • Chest pain or pressure
  • Difficulty breathing or shortness of breath
  • Severe bleeding or trauma
  • Signs of stroke (facial drooping, arm weakness, speech difficulty)
  • Suicidal or homicidal thoughts
  • Self-harm or thoughts of self-harm
  • Psychosis, hallucinations, or severe confusion
  • Acute psychiatric crisis or severe panic attacks
  • Severe allergic reactions
  • Loss of consciousness
  • Severe abdominal pain
  • High fever with confusion
  • Any condition you believe requires immediate medical attention

Right to Alternative Care

You have the right to request in-person care or a video consultation at any time. If our providers determine that your condition requires in-person evaluation, we will recommend appropriate referrals.

Technology Requirements and Risks

You understand that telehealth services depend on technology that may fail, including internet connectivity, mobile networks, and software applications. Communication delays may occur. While we implement security measures, electronic communications carry inherent privacy and security risks.

Prescription Limitations

Pascal Medical may prescribe medications when clinically appropriate based on telehealth evaluation. However, the following limitations apply:

Controlled Substances

In accordance with New York and New Jersey state laws and federal regulations:

  • Schedule II controlled substances (such as certain stimulants and opioids) generally require an initial in-person examination before prescribing, with limited exceptions under state and federal law.
  • In New Jersey, patients receiving Schedule II controlled substances require in-person follow-up visits every three months.
  • We may decline to prescribe controlled substances via text-based consultation when clinical circumstances warrant in-person evaluation.

Medications We May Not Prescribe

Certain medications may not be prescribed through our text-based Services, including but not limited to medications that require in-person monitoring, medications with high abuse potential, and medications that require laboratory monitoring not available through our Service.

Clinical Discretion

All prescribing decisions are made at the sole clinical discretion of Pascal Medical providers. We reserve the right to decline any prescription request when, in our clinical judgment, text-based evaluation is insufficient or the requested medication is not appropriate.

Eligibility

The Services are available only to individuals who are 18 years of age or older. By using the Services, you represent and warrant that you are at least 18 years old and have the legal capacity to enter into these Terms. If you are under 18 years of age, you may not use the Services.

Geographic Restrictions

The Services are currently available only to residents of New York and New Jersey. By using the Services, you represent and warrant that you are located in one of these states. We make no representation that the Services are appropriate or available for use in other locations.

Updates to the Terms

We may modify these Terms from time to time. We will notify you of material changes by posting the amended terms on our website at least fifteen (15) days before the effective date of the changes. If we have your email on file, we may also notify you of material changes by email. If you do not agree with the proposed changes, you agree to discontinue your use of the Site before the effective date of the changes. If you continue using the Site after the effective date, you will be bound by the updated Terms.

Account Registration and Security

You may use the Site only for your own personal, non-commercial use. To access certain features of the Site or to become a member, you will have to create an account by entering your name, address, and certain other information collected by Pascal (collectively, "Account Information"). It is important that you provide us with accurate and complete Account Information and update as needed. You are responsible for protecting your account username and password, and for all activities that occur under your account. You should immediately notify us of any unauthorized use of your account.

Service Use Termination

You may terminate these Terms by ceasing to access and use the Site. We may terminate your use of the Site at any time by sending notice to you at the address or email you provided. If we terminate your use of the Site because you have breached these Terms or any other agreement you have entered into with us, you will not be entitled to any refunds of services provided, except as set forth in the Refund Policy below.

Use of the Services

Subject to your compliance with these Terms, we grant you a limited, non-exclusive, non-transferable, non-sublicensable license to use the Site solely for your personal and non-commercial purposes. Your use of the Site must be in accordance with all applicable laws. You acknowledge that you do not acquire any ownership rights in the Site.

You agree not to: (a) engage in defamatory, abusive, or harassing behavior; (b) use any automated systems to access the Site; (c) interfere with the Site or servers; (d) attempt to breach any security measures; (e) use the Site for any commercial purpose; (f) provide inaccurate information; (g) allow others to use your account; or (h) assist others in any prohibited activities.

Payment and Billing

By providing a credit card or other payment method that we accept, you represent and warrant that you are authorized to use the designated payment method and that you authorize us (or our third-party payment processor, Stripe) to charge your payment method for the total amount of your purchase (including any applicable taxes and other charges). If the payment method cannot be verified, is invalid, or is otherwise not acceptable, your transaction may be suspended or canceled.

Subscription and Fees

When you register for a subscription ("Subscription"), you expressly acknowledge and agree that (a) your Subscription automatically renews and Pascal (or our third-party payment processor) is authorized to charge you on a recurring basis for your Subscription for as long as your Subscription continues, and (b) your Subscription continues to automatically renew until you cancel it or we suspend or stop providing access to the Site in accordance with these Terms.

You may cancel your Subscription at any time by contacting pascal@textpascal.com. We reserve the right to change Subscription prices at any time in our sole discretion. If prices are changed, you will be notified by email prior to the change.

Refund Policy

Any fees may be refunded upon request made within thirty (30) days of billing. To request a refund, please contact pascal@textpascal.com. The final decision to issue a refund rests solely with Pascal in its discretion. We reserve the right to deny refund requests to prevent abuse of this policy, including but not limited to multiple or frequent refund requests from the same user.

Consent to Electronic Communications

You agree that we may send to you by email, text message, or by posting on the Site: legal disclosures, privacy notices, these Terms, and other notices related to the Services. You agree that we may communicate with you via email, phone, text, or through the Spruce Health mobile application regarding the Services.

Text messages and emails are not always secure because they travel over networks that we do not own or control. You consent to receive such communications electronically.

Intellectual Property Rights

Pascal and our licensors retain all ownership rights, title, and interest (including all intellectual property rights) worldwide to the Site and the Services, including all software and content. No rights are granted to you other than as expressly set forth in these Terms. All trademarks, service marks, and trade names are owned by Pascal or their respective owners.

Links to Third Party Websites

The Site may contain links to other sites that are owned and operated by third parties. We are not responsible for the privacy and security practices or the content of any such linked sites. The inclusion of any link does not imply endorsement by us.

No Warranty

ACCESS TO THE SITE AND THE INFORMATION CONTAINED THEREIN IS PROVIDED "AS IS" AND "AS AVAILABLE" WITHOUT ANY WARRANTY OF ANY KIND, EXPRESS OR IMPLIED. PASCAL DOES NOT WARRANT THE ACCURACY, COMPLETENESS, OR TIMELINESS OF THE MATERIALS ON THIS SITE AND TO THE FULLEST EXTENT PERMISSIBLE PURSUANT TO APPLICABLE LAW, PASCAL DISCLAIMS ALL WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, OR NON-INFRINGEMENT. YOU EXPRESSLY AGREE THAT YOUR USE OF THE SITE AND YOUR RELIANCE UPON ANY OF ITS CONTENTS IS AT YOUR SOLE RISK.

Limitation of Liability

Pascal (Administrative Services)

PASCAL (DBA ROUNDTABLE DIAGNOSTICS, LLC) PROVIDES ONLY ADMINISTRATIVE AND TECHNOLOGY SERVICES. PASCAL DOES NOT PROVIDE MEDICAL CARE, EMPLOY PHYSICIANS, OR MAKE CLINICAL DECISIONS. TO THE FULLEST EXTENT PERMITTED BY LAW, PASCAL SHALL NOT BE LIABLE FOR ANY DIRECT, INDIRECT, SPECIAL, PUNITIVE, INCIDENTAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES ARISING FROM ITS ADMINISTRATIVE OR TECHNOLOGY SERVICES, INCLUDING BUT NOT LIMITED TO DAMAGES FROM TECHNOLOGY FAILURES, COMMUNICATION DELAYS, OR PLATFORM UNAVAILABILITY.

Pascal Medical (Clinical Services)

PASCAL MEDICAL IS AN INDEPENDENT MEDICAL PRACTICE THAT PROVIDES CLINICAL SERVICES. LIABILITY FOR CLINICAL SERVICES PROVIDED BY PASCAL MEDICAL IS GOVERNED BY APPLICABLE MEDICAL MALPRACTICE AND PROFESSIONAL LIABILITY LAWS. NOTHING IN THESE TERMS SHALL BE CONSTRUED TO LIMIT LIABILITY FOR PROFESSIONAL MEDICAL MALPRACTICE TO THE EXTENT SUCH LIMITATION IS PROHIBITED BY LAW.

Acknowledgment of Telehealth Limitations

By using our text-based telehealth Services, you acknowledge that you have read and understand the limitations of text-based medical care as described in the "Telehealth Services and Informed Consent" section above, including conditions that are not appropriate for text-based care.

Dispute Resolution

Any dispute, claim, or controversy between you and Pascal arising from or relating to these Terms, your use of the Site, or any services provided (collectively, "Covered Disputes") will be resolved by binding arbitration, rather than in court.

Mandatory Informal Dispute Resolution

Before formally pursuing a Covered Dispute in arbitration, you agree to first send a detailed notice ("Notice") to Pascal by email at pascal@textpascal.com. Your Notice must contain: (1) your full name; (2) your address, telephone number, and email address; and (3) a detailed description of your dispute. You and Pascal agree to negotiate in good faith about the dispute. This process should result in resolution of the dispute, but if it is not resolved within 60 days after receipt of a Notice, you may initiate an arbitration.

Arbitration Rules

Any arbitration shall be administered by National Arbitration and Mediation ("NAM") in accordance with NAM's Comprehensive Dispute Resolution Rules and Procedures in effect at the time any demand for arbitration is filed. If NAM is unavailable, the arbitration shall be administered by the American Arbitration Association ("AAA") pursuant to the AAA Consumer Arbitration Rules. Any arbitration will be held before a single neutral arbitrator.

Jury Trial and Class Action Waiver

TO THE FULLEST EXTENT PERMITTED BY LAW, YOU AND PASCAL ACKNOWLEDGE AND AGREE THAT YOU ARE EACH WAIVING THE RIGHT TO A TRIAL BY JURY AND TO THE LITIGATION OF DISPUTES IN STATE OR FEDERAL COURTS OF GENERAL JURISDICTION. THE PARTIES FURTHER AGREE THAT ANY ARBITRATION SHALL BE CONDUCTED IN THEIR INDIVIDUAL CAPACITIES ONLY AND NOT AS A CLASS ACTION OR OTHER REPRESENTATIVE ACTION, AND THE PARTIES EXPRESSLY WAIVE THEIR RIGHT TO FILE A CLASS ACTION OR SEEK RELIEF ON A CLASS BASIS.

Governing Law

These Terms are governed by the Federal Arbitration Act ("FAA") and federal law. Where otherwise applicable, the laws of the State of New York apply. Should any action proceed in court, you consent to the exclusive jurisdiction of the federal and state courts located in New York.

General Provisions

These Terms make up the entire agreement relating to your use of the Services and supersede all prior agreements relating to the subject matter hereof. We may change, suspend, or discontinue any of the Services at any time. You may not transfer any of your rights or obligations under these Terms to anyone else without our consent. Pascal may assign our rights in connection with a merger, acquisition, or sale of assets, or by operation of law or otherwise.

Even after termination, these Terms will remain in effect such that all terms that by their nature may survive termination will be deemed to survive such termination.

Contact Us

If you have any questions about these Terms, please contact us via email at pascal@textpascal.com