Telehealth Informed Consent

What telehealth is

Telehealth is the delivery of health care services using electronic communications, such as secure messaging, questionnaires, photos, and audio or video visits, when you and your clinician are not in the same place.

Benefits

• Convenient access to a licensed clinician without travel.
• Care on your schedule, with secure follow-up messaging.

Risks and limitations

• A clinician cannot perform a hands-on physical examination.
• Information you provide may be incomplete, which can affect clinical decisions.
• Technology failures may delay evaluation or treatment.
• Despite reasonable safeguards, electronic communications carry a risk of unauthorized access.
• Your clinician may determine that telehealth is not appropriate and refer you to in-person care.

Your responsibilities

• Provide complete, accurate, and current health information.
• Tell your clinician about all medications, supplements, and conditions.
• Follow up with in-person care when recommended.
• Seek emergency care by calling 911 for any medical emergency. Telehealth is not for emergencies.

Clinical judgment

Clinicians are licensed in the state where you are located at the time of your visit and use their independent professional judgment. Completing intake does not guarantee a prescription or any specific treatment.

Your consent

By beginning intake, you confirm that you have read this consent, have had the opportunity to ask questions, and agree to receive care via telehealth. You may withdraw consent at any time without affecting your right to future care.