Telehealth Consent Form

Last updated: [DATE]

What is Telehealth?

Telehealth involves the use of electronic communications to enable healthcare providers to connect with patients for diagnosis, consultation, treatment, therapy, follow-up and/or education.

Benefits of Telehealth

  • Improved access to medical care by enabling a patient to remain at home
  • More efficient medical evaluation and management
  • Reduced travel time and cost for patients
  • Continuity of care during emergencies or when physically unable to visit

Risks and Limitations

  • Technology failures or poor connection quality may interrupt the session
  • Some medical conditions require in-person physical examination
  • Delays in medical evaluation and treatment could occur due to technical difficulties
  • Security protocols could fail, causing a breach of privacy of personal medical information

Patient Responsibilities

  • Ensure you have a stable internet connection
  • Find a private, quiet location for your appointment
  • Have a list of your current medications available
  • Be prepared to provide your current location in case of emergency
  • Understand that telehealth is not appropriate for emergency situations

Privacy and Security

We use secure, encrypted platforms for all telehealth sessions. However, no technology is 100% secure, and there is always a risk that transmitted information could be intercepted by unauthorized individuals.

Emergency Situations

If you are experiencing a medical emergency, do not use telehealth services. Call 911 or go to the nearest emergency room immediately.

Consent

By using our telehealth services, you acknowledge that you have read and understood this consent form and agree to the terms and conditions outlined above.

Questions or Concerns

If you have any questions about telehealth services or this consent form, please contact us at [CONTACT_INFO].