Telehealth Informed Consent

I consent to receive healthcare via telehealth, including asynchronous text-based intakes and synchronous video visits.

What I Understand

Telehealth visits are documented in my medical record the same way as in-person visits.

The provider may decide a condition is better managed in-person and refer me to a local clinic if necessary.

Technical issues (poor connection, dropped call) may interrupt a visit; the provider will reschedule at no additional cost.

My healthcare information is protected under HIPAA and shared only with my care team and as required by law.

I may withdraw consent for telehealth at any time without affecting my access to in-person care.

Your Agreement

By checking the Telehealth Informed Consent box at signup, you confirm that you have read and understood this consent and agree to evaluation and treatment via telehealth. A timestamped record of your agreement is kept with your account.