Legal Disclosures
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Authorization and Consent to Participate in Telemedicine/Telehealth Consultation
By using our Services, you agree to be bound by the contents of this form.
During a telemedicine consultation
a). Details about you and/or your medical history, including without limitation, examinations, and laboratory tests, will be discussed with other health professionals through the use of interactive video, audio and telecommunications technology.
b). Physical examinations of you may be rendered
c). Non-medical technical personnel may be present in the telemedicine studio to aid in the conducting of the consultation.
d). Non-medical technical personnel may be present in the telemedicine studio to aid in the conducting of the consultation.
1.
Medical Information and Records
All existing laws regarding your access to medical information and copies of your medical records apply to this consultation. Additionally, dissemination of any patient-identifiable images or information from this consultation to researchers or other entities shall not occur without your consent, unless authorized under existing confidentiality laws.
2.
Confidentiality
Commercially reasonable and appropriate efforts have been made to eliminate confidentiality risks associated with the telemedicine consultation. All existing confidentiality protections under federal and state law apply to information disclosed during this consultation.
3.
Risks and Benefits
The benefits of telemedicine include, without limitation, having access to medical specialists and additional medical information and education without having to travel outside of your home. There are potential risks though, including, without limitation, that because of your specific medical condition, or due to technical problems, a face-to-face consultation still may be necessary after the telemedicine appointment. Additionally, in rare circumstances, technology security protocols could fail causing a breach of patient privacy.
4.
