Telehealth Informed Consent
General information about receiving healthcare through electronic communications and remote technology.
Nature of telehealth
Telehealth uses electronic communications to allow a patient and licensed healthcare provider in different locations to exchange medical information, conduct an evaluation and discuss care. Technology may include secure questionnaires, messaging, audio or video communications and electronic records.
Potential benefits
- Convenient access without routine travel
- More efficient communication and follow-up
- Coordination with pharmacies and other care participants
Potential risks and limitations
- Technology failures, delays or interruptions
- Privacy or security risks despite reasonable safeguards
- Limitations caused by the absence of an in-person examination
- Incomplete or inaccurate information affecting clinical decisions
- A provider determining that in-person or emergency care is required
Patient responsibilities
You agree to provide accurate identity, location, health-history, medication and symptom information; participate from a reasonably private location; ask questions; follow care instructions; and notify the provider of changes. You must be physically located in a jurisdiction where the provider is authorized to treat you.
Prescribing
Telehealth participation does not guarantee a prescription. A provider may decline treatment, request records or testing, refer you for in-person care, or recommend a different approach. A licensed pharmacy dispenses prescription medication only after receiving a valid prescription.
Privacy
Telehealth participants use reasonable safeguards, but electronic communication carries inherent risk. Use the designated secure intake and patient portal for health information. Applicable provider privacy notices may separately govern protected health information.
Emergencies and withdrawal
Telehealth is not for emergencies. Call 911 or seek immediate care for urgent symptoms. You may withdraw consent to future telehealth services, subject to obligations already incurred and the need to arrange safe continuity of care.
Acknowledgment
Submitting the designated consent during intake confirms that you understand the nature, benefits, risks and alternatives of telehealth and had an opportunity to ask questions. This website copy is informational; the clinical provider may present an additional consent governing care.