TELEHEALTH INFORMED CONSENT
Telehealth Informed Consent Agreement
Redefined Health & Wellness LLC
Telehealth involves the use of electronic communications to enable healthcare services when the patient and provider are not physically located in the same place.
Nature of Telehealth
I understand that telehealth may include:
Medical evaluations
Consultations
Follow-up care
Education and counseling
Treatment recommendations
Potential Benefits
Benefits may include:
Improved access to healthcare
Reduced travel time
Increased convenience
Continuity of care
Potential Risks
Risks may include:
Technical failures
Internet interruptions
Unauthorized access despite security measures
Incomplete transmission of information
Emergencies
I understand telehealth is not intended for emergencies.
If I experience a medical emergency, I will:
Call 911
Proceed to the nearest emergency department
Contact local emergency services
Privacy
Reasonable efforts will be made to protect confidentiality and comply with applicable privacy laws.
Patient Responsibilities
I agree to:
Provide accurate medical information
Participate in a private setting when possible
Notify the provider of any changes in my condition
Consent
By utilizing telehealth services, I acknowledge that:
I have read and understand this consent.
My questions have been answered.
I voluntarily consent to receive telehealth services.