Effective Date:  April 7, 2026

I hereby consent to the provision of preventive magnetic resonance imaging (“MRI”) screening, MRI reading and interpretation, administrative, technology, telehealth, and related services to and/or for me, as well any elected additional services (collectively, “Services”), as further described and explained herein.

I understand that the Services are provided by Innovative Body Scan, LLC d/b/a Dragonfly (“Dragonfly”) and/or its affiliated medical practices, which vary depending on the location where I receive services (collectively referred to as “Dragonfly Medical”). Dragonfly Medical includes the affiliated medical practices set forth on the Exhibit below, which may be updated from time to time. To provide the Services, Dragonfly or Dragonfly Medical (as applicable) employ or contract with physicians and allied health professionals (each, a “Professional”), which consist primarily of radiologists, physicians, and nurse practitioners.

I acknowledge that this Consent reviews the benefits, risks, and limitations of the Services, and I acknowledge that Dragonfly recommends consulting with my primary, ordering, or referring physician or healthcare provider (“My Physician”) for further guidance about the Services before signing this Consent. I understand that, as noted above, Dragonfly Medical employs or contracts with Professionals to provide medical services as part of the Services, including reviewing and reading MRI results. I acknowledge and agree that any decisions regarding diagnosis or treatment, or both, rest with me and My Physician, not with Dragonfly, Dragonfly Medical, or the Professionals, and I agree that I should always contact My Physician directly with any questions regarding my personal health or medical conditions.

Consent to Telehealth

I understand that, as part of the Services, Dragonfly will provide certain administrative and technical services to facilitate connecting me with Dragonfly Medical and/or a Professional via Dragonfly’s online telehealth platform and other communications channels to provide consultation regarding any clinically significant findings from my MRI (“Telehealth”), including the associated exchange of personal and health information, email, telephone communication, and educational material. I acknowledge that Telehealth involves the use of electronic communications. I hereby consent to engage in Telehealth with a Professional.

I understand that the expected benefits of Telehealth include improved access to professional consultation enabling me to remain at a remote site while the Professional is at a distant site, more efficient evaluation and management, and obtaining the expertise of a distant Professional who is licensed in the state where I reside (as disclosed by me). I understand that the Professional may discuss any borderline or clinically significant findings with me during a Telehealth visit. Findings that are clinically significant consist of any new or unexpected irregularities, conditions, or diagnoses, or any material changes to my known, pre-existing medical conditions, that are revealed in the reading of an MRI report and that could lead to the development of a significant disease, medical condition, or adverse outcome if not treated. I understand that I am responsible for discussing any follow-up care or treatment with My Physician, and I agree that the Professional is not responsible for ongoing medical care or treatment.

I understand that I have a right to confidentiality with Telehealth under the same laws that protect the confidentiality of my personal and health information for in-person health services. Any information disclosed by me during the course of my Telehealth, therefore, is generally confidential to the extent provided by law.

I realize that, as with any medical care, there are potential risks associated with the use of Telehealth. These risks include, but may not be limited to: (a) in rare cases, information transmitted may not be sufficient (e.g. poor resolution of images) to allow for appropriate professional decision making by the Professional; (b) delays in evaluation and treatment could occur due to deficiencies or failures of the equipment or temporary unavailability of a Professional; and (c) disruption, distortion, or unauthorized access during transmission of personal information are possible due to internet/electronic/technical failures beyond the control of Dragonfly, Dragonfly Medical, and any Professional.

Limitations of Screening

I understand that Dragonfly and Dragonfly Medical provide non-contrast MRI-based wellness and preventive screening Services intended for asymptomatic individuals. The Services are intended as a preventive measure to potentially identify the presence of certain medical conditions under optimal conditions. The Services are not a medical test and are not a substitute for comprehensive clinical evaluation, physician consultation, or diagnostic imaging ordered for known or suspected medical conditions. The screening protocols offered by Dragonfly and/or Dragonfly Medical are designed to identify potential abnormalities that may warrant further clinical evaluation. However, no screening can detect all diseases or conditions. I understand that certain medical conditions, early-stage diseases, microscopic pathology, functional disorders, or conditions outside the scope and technical limitations of MRI may not be visualized or detected. Further, as with all medical tests, there is a chance of a false positive or false negative result. The decision to order any additional tests or perform any procedure must be made by me and My Physician, and not by any Professional, Dragonfly Medical, or Dragonfly. There may also be subtle indicators that could be found to be present on imaging but the significance may not be apparent at the time the image was read and interpreted in connection with the Services. I understand that it is not possible for the screening report to reveal every subtle finding, and no imaging technique including the Services can guarantee detection of all conditions at an early or treatable stage. Anatomical variations in my organs or other parts of my body may also affect the accuracy, coverage, or comprehensiveness of the results.

I further understand and agree that Dragonfly and Dragonfly Medical do not provide medical treatment or a physician–patient relationship for longitudinal care, and none of the Professionals replace the role of a primary care provider or specialist, or My Physician. Any findings, including a review of the imaging report and the nature and limitations of MRI technology, should be discussed with My Physician for appropriate correlation and follow-up. None of Dragonfly, Dragonfly Medical, or any Professionals assume responsibility for my ongoing medical care. In many instances the Services may detect an abnormality without rendering a definitive diagnosis.

I acknowledge that no guarantee is made that all disease, cancer, vascular abnormalities, or other medical conditions will be detected by the Services. A normal screening result does not eliminate the possibility of current or future disease. I acknowledge that certain disease processes, early-stage pathology, microscopic disease, inflammatory, functional, metabolic, or rapidly evolving conditions may not be detected. Findings should be interpreted in conjunction with my medical history and correlated with additional diagnostic testing as deemed appropriate by me and My Physician. I further understand MRI screening results provided as part of the Services do not exclude the presence of or future development of disease. I understand that the Services do not replace other medical scans, treatments, screenings, and approaches to monitoring and managing my health such as annual visits with My Physician and other screenings recommended by My Physician such as colonoscopy, mammogram, pap-smear screening, vaccinations, blood tests, etc. The Services are not a substitute for My Physician’s clinical evaluation and judgment.

The Services are limited in the evaluation of many organs and parts of my body, including gastrointestinal tract, heart, skin, lungs, joints and soft tissue, and testes. In addition, the Services are not intended or optimized to evaluate for suspected, known active, or known recent (i.e., within the last 5 years) cancer. I understand that if I am concerned about such cancer screening, I should seek advice from My Physician and my other medical providers prior to undertaking the Services. I acknowledge that I must disclose any cancer diagnosis to Dragonfly in the medical information intake process, and I understand that, as a result, I may not meet the qualifications for the Services.

Appropriateness of the Screening

I understand that, as set forth above, the Services are designed for screening of asymptomatic individuals. The purpose of the Services is preventive assessment only and is not intended to evaluate known or suspected disease, acute symptoms, or specific clinical complaints.

A Professional will review my medical history and other relevant information I provide in my medical intake form, including my health information and my family health information. If an MRI screening is appropriate, an appropriately licensed Professional will order the screening, to be provided as part of the Services. It is my responsibility to provide complete and accurate information in the medical intake process. Any health information that is not disclosed by me in the medical intake process may not be taken into consideration when determining the appropriateness of the contemplated screening. The absence or any inaccuracy of health information about me also may impact the interpretation of results. I acknowledge and agree that any failure to include complete and accurate information in the medical intake process may result in potential injuries or negative outcomes and may impact results and interpretation of results. If I withhold or fail to accurately provide relevant information contrary to these instructions, I accept responsibility for any adverse outcomes, limitations, or issues that may result.

MRI Consent

Magnetic resonance imaging (MRI) is a type of scan that uses radio waves to take detailed pictures of the body. I will be asked to lie on an MRI table where the technician will place a receiver on the part of my body to be studied. The technician will slowly slide me into the MRI magnet tunnel where radio waves will be transmitted into my body. I acknowledge that I must complete a screening evaluation form in advance of the MRI screening for the presence of medical implants or other foreign bodies that could pose an injury when undergoing MRI. This screening is only as effective as the information provided by me. In cases where there is insufficient information to evaluate the risks associated with an implant or foreign body, the MRI will not proceed. Because of the magnetic field and radio frequencies, people with a heart pacemaker, brain aneurysm clips, and some implanted metallic or electrical devices should not have an MRI. I agree to follow all preparatory instructions including on the day of the screening MRI.

There is a potential risk of MRI for participants with medical implants or other metallic objects in their body. All participants undergoing MRI scanning must complete a screening evaluation in advance of the study for the presence of medical implants or other foreign bodies that could pose an injury. Every effort will be made to ensure that disclosed implants or foreign bodies do not pose a risk to participants. In cases where there is insufficient information to evaluate the risks associated with an implant or foreign body, the MRI study will not be allowed to proceed.

Possible side effects related to the MRI process include anxiety/stress, claustrophobia, discomfort, nausea/vomiting, and tingling in arms. Rare but serious side effects of the strong MRI magnetic fields may include physical injury and/or medical device damage related to the presence of metallic or surgical implants or metal pieces in the body. The magnetic field also poses risks to personal injury or damage associated with wearable sensors, medicinal patches, certain types of tattoos, and hair weaves containing metallic threads. Although there are no established high risks of harm from MRI on pregnant participants or a fetus, there is a possibility of yet undiscovered pregnancy-related risks. Thus, MRI screening is not recommended if you know you are pregnant.

Please note that radiology often requires the reading radiologist or other Professional to form a considered subjective opinion based on the interpretation of images that do not present clear-cut indicators or definitively suggest one particular finding or diagnosis over another. You understand and agree that there are often reasonable differences of opinion between experienced radiologists as to certain findings and diagnoses, each of which can be justified according to a body of responsible medical opinion.

Limitation of Liability

DRAGONFLY, DRAGONFLY MEDICAL, AND THE APPLICABLE PROFESSIONAL(S) PROVIDE PREVENTATIVE SCREENING SERVICES, NOT DIAGNOSTIC SERVICES. THE PREVENTATIVE SCREENING SERVICES ARE NOT A SUBSTITUTE FOR DIAGNOSTIC SERVICES. EXCEPT AS MAY BE EXPRESSLY PROVIDED HEREIN AND TO THE FULLEST EXTENT PERMITTED BY LAW, I ACKNOWLEDGE AND AGREE THAT DRAGONFLY, DRAGONFLY MEDICAL, AND PROFESSIONAL(S) SHALL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, OR PUNITIVE DAMAGES (EVEN IF DRAGONFLY, DRAGONFLY MEDICAL AND THE APPLICABLE PROFESSIONAL(S) HAVE BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES), WHETHER BASED ON CONTRACT, TORT (INCLUDING NEGLIGENCE), STRICT LIABILITY OR ANY OTHER LEGAL THEORY, RESULTING FROM, ARISING FROM, OR RELATED TO: (A) THE SERVICES OR MY USE OF OR INABILITY TO USE THE SERVICES; (B) THIS CONSENT; (C) ANY DEFECT OR FAILURE OF MRI OR OTHER EQUIPMENT OR ANY PREMISES CONDITION AT ANY IMAGING LOCATION TO WHICH I AM DIRECTED IN CONNECTION WITH THE SERVICES; (D) ANY ABUSIVE OR OTHERWISE IMPROPER CONDUCT BY ME IN CONNECTION WITH THE SERVICES (WHETHER IN-PERSON OR VIA TELEHEALTH); (E) ANY INCOMPLETE OR INACCURATE INFORMATION PROVIDED BY OR CONCERNING ME; (F) MY FAILURE TO COOPERATE OR FOLLOW REASONABLE INSTRUCTIONS; (G) THE LIMITATIONS OF MRI TECHNOLOGY AND TELEHEALTH; OR (H) ANY SERVICES PROVIDED BY A THIRD PARTY (i.e.., A PERSON OR ENTITY OTHER THAN DRAGONFLY, DRAGONFLY MEDICAL, AND APPLICABLE PROVIDER(S)).

I AGREE THAT IF I AM DISSATISFIED WITH ANY ASPECT OF THE SERVICES, MY SOLE AND EXCLUSIVE REMEDY IS TO DISCONTINUE USE OF THE SERVICES. IF A MONETARY REMEDY IS NONETHELESS AVAILABLE TO ME, I AGREE THAT THE AGGREGATE MONETARY REMEDY AVAILABLE TO ME IN CONNECTION WITH ANY SET OF RELATED CLAIMS ASSERTED AGAINST DRAGONFLY, DRAGONFLY MEDICAL, OR, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, PROFESSIONAL(S) ARISING FROM OR RELATED TO THE SERVICES, WHETHER BASED ON CONTRACT, TORT, NEGLIGENCE, STRICT LIABILITY OR ANY OTHER LEGAL THEORY, SHALL BE $100,000.00.

NOTWITHSTANDING THE PREVIOUS TWO PARAGRAPHS, I UNDERSTAND THAT SOME JURISDICTIONS DO NOT PERMIT CERTAIN LIMITATIONS OF LIABILITY; IF SO, THOSE LIMITATIONS DO NOT APPLY TO ME. IF ANY PORTION OF THE FOREGOING LIMITATIONS IS IMPERMISSIBLE UNDER APPLICABLE LAW AND/OR IS HELD TO BE INVALID, THE REMAINING PORTION(S) OF SUCH LIMITATIONS SHALL BE AND REMAIN VALID TO THE FULLEST EXTENT PERMISSIBLE UNDER APPLICABLE LAW.

I ACKNOWLEDGE THAT MY AGREEMENT TO THE FOREGOING LIMITATIONS OF LIABILITY IS A FUNDAMENTAL AND MATERIAL TERM OF THE BARGAIN BETWEEN DRAGONFLY, DRAGONFLY MEDICAL, AND, TO THE FULLEST EXTENT PERMITTED BY APPLICABLE LAW, PROFESSIONALS, ON THE ONE HAND, AND ME, ON THE OTHER HAND.

THE DISPUTE RESOLUTION, VENUE, CLASS ACTION WAIVER, GOVERNING LAW, AND LIMITED TIME TO FILE CLAIMS PROVISIONS SET FORTH IN SECTIONS 13, 14, AND 15 OF THE TERMS OF SERVICE ARE HEREBY INCORPORATED HEREIN BY REFERENCE

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By signing this form, I agree to the terms and provisions of this Consent, including without limitation the following:

1. I understand that if, at any time, I am experiencing a medical emergency or a crisis, I should dial 9-1-1 immediately. Dragonfly is not able to connect me directly to any local emergency services.
2. I hereby consent to the provision of professional health care consultation services to me via Telehealth. I understand that I have the right to withhold or withdraw my consent to the use of Telehealth by a Professional at any time, without affecting my right to future care or treatment. I understand that a variety of alternative methods of health care may be available to me, and that I may choose one or more of these at any time. I understand that Telehealth services may not be as complete as face-to-face services.
3. I understand that I may be required to have certain system requirements to access electronic Telehealth services. I understand that I am solely responsible for any cost to obtain any additional/necessary system requirements, accessories, or software to use Telehealth services.
4. I consent to undergoing an in-person MRI screening as part of the Services at a Dragonfly imaging location and confirm that I have no medical implants or other metallic objects in my body.
5. I understand that I am solely responsible for the privacy and confidentiality in my surrounding environment while engaged in Telehealth and will exercise appropriate privacy measures.
6. I agree that if it becomes clear to the Professional, in his or her sole professional opinion, that the Telehealth modality is unable to provide pertinent clinical information during the Telehealth encounter, the Professional will advise me prior to the conclusion of the live Telehealth encounter and will advise me regarding the need for me to obtain an in-person evaluation from a qualified medical professional reasonably able to meet my needs.
7. I have been given an opportunity to approve or select a Professional for my Telehealth session, including a review of the Professional’s credentials.
8. I understand there is a risk of technical failures during the Telehealth encounter beyond the control of Dragonfly, Dragonfly Medical, or any Professional. I agree that Dragonfly, Dragonfly Medical, and the applicable Professional are not responsible for delays in evaluation, lapses in communication, or for information lost due to such technical failures.
9. I acknowledge that the Services are provided for screening and educational purposes only and are not a substitute for diagnostic or treatment services. I acknowledge that: (a) no screening test can detect all diseases, and any screening is subject to limitations including those discussed in this Consent; (b) certain cancers, vascular abnormalities, or other conditions may not be visible on MRI; (c) a normal result does not guarantee the absence of disease; and (d) further diagnostic evaluation may be necessary based on findings or future symptoms.
10. I acknowledge and agree that any failure to include complete and accurate information in my medical intake forms may result in potential injuries or negative outcomes and may impact results and interpretation of results.
11. I acknowledge that portions of image post-processing, quantitative analysis, and/or reporting support may incorporate artificial intelligence (AI)–assisted software tools (“AI Tools”). These tools function solely as adjunctive decision-support systems and all imaging findings and clinical interpretations are reviewed, verified, and finalized by a licensed, board-certified radiologist contracted by Dragonfly or Dragonfly Medical, as applicable.

I have read and understand the information provided above regarding the Services including Telehealth and all of my questions, if any, have been answered to my satisfaction. By clicking the “I AGREE” button, I am authorizing Dragonfly, Dragonfly Medical, and Professionals to provide the screening and other Services, and I confirm my agreement and understanding of the statements set forth above. I hereby give my informed consent and authorization for the applicable Professionals to use Telehealth in my healthcare and for the provision of Services to me.