Telehealth Consent

Effective Date: 03/08/2026
Last Updated: 03/08/2026

This Telehealth Informed Consent ("Consent") describes the risks, benefits, and alternatives to receiving healthcare services through telehealth technology provided via [Company Name] (the "Platform").

By using our telehealth services, you acknowledge that you have read, understand, and agree to the terms described in this Consent.

1. What is Telehealth

Telehealth involves the use of electronic communications and information technology to provide healthcare services remotely.

Telehealth services may include:

  • Live video consultations

  • Remote medical evaluations

  • Diagnosis and treatment recommendations

  • Prescription management where appropriate

  • Electronic communication between you and your healthcare provider

These services allow healthcare providers to deliver care without requiring an in-person visit.

2. Nature of Telehealth Services

During a telehealth visit:

  • Details of your medical history, symptoms, and health concerns may be discussed.

  • Audio, video, and other electronic communications may be used to facilitate care.

  • The healthcare provider may determine whether telehealth is appropriate for your condition.

In some cases, your provider may recommend in-person care, additional testing, or referral to another healthcare professional.

3. Potential Benefits

Telehealth services may offer several potential benefits, including:

  • Improved access to healthcare services

  • Reduced travel time and associated costs

  • Increased convenience and flexibility

  • Faster access to medical guidance

However, results and outcomes cannot be guaranteed.

4. Potential Risks and Limitations

Telehealth services also involve certain risks and limitations, including:

  • Technical failures that may interrupt the consultation

  • Reduced ability to perform a full physical examination

  • Possible delays in medical evaluation if technology fails

  • Potential privacy or security risks related to electronic communication

Your healthcare provider may determine that telehealth is not appropriate for your condition and may recommend an in-person visit.

5. Privacy and Confidentiality

Your telehealth visit will be conducted using secure technology designed to protect your privacy.

Your personal and health information will be handled in accordance with our Privacy Policy and applicable healthcare privacy laws, including HIPAA, where applicable.

However, no electronic communication system can guarantee absolute security.

6. Patient Responsibilities

By using telehealth services, you agree to:

  • Provide accurate and complete medical information

  • Inform your provider of any changes to your health condition

  • Use the telehealth platform in a private and secure location when possible

  • Ensure that you have adequate technology and internet connectivity for your visit

7. Emergency Situations

Telehealth services are not appropriate for emergency medical situations.

If you believe you are experiencing a medical emergency, you should:

  • Call 911, or

  • Go to the nearest emergency room immediately.

8. Voluntary Participation

Participation in telehealth services is voluntary.

You may withdraw your consent to telehealth services at any time by notifying your healthcare provider.

If you withdraw consent, you may need to seek care through in-person healthcare services.

9. Recording of Sessions

Telehealth sessions will not be recorded without your consent.

If recording is necessary for clinical, training, or quality assurance purposes, you will be informed and asked for permission beforehand.

10. Prescriptions

Healthcare providers may prescribe medications when medically appropriate and permitted by law.

However:

  • Not all medical conditions are appropriate for treatment through telehealth.

  • Certain medications may require an in-person evaluation before they can be prescribed.

Prescription decisions remain at the discretion of the licensed healthcare provider.

11. Consent to Telehealth

By proceeding with telehealth services through the Platform, you acknowledge that:

  • You have read and understand this Telehealth Informed Consent

  • You have had the opportunity to ask questions about telehealth services

  • You understand the risks, benefits, and alternatives

  • You voluntarily consent to receive healthcare services through telehealth technology