Informed Consent for Telehealth

What telehealth means here

Telehealth is the delivery of health care using electronic communication rather than an in-person visit. At this practice it includes a structured medical intake you complete online, review of that intake by a clinician licensed in your state, secure messaging with your care team, and video or telephone consultation where clinically indicated.

Benefits

• Access to a licensed clinician without travel or waiting rooms.
• Care in states and areas where relevant specialists are not locally available.
• A written record of your treatment plan you can refer back to.

Limitations and risks, stated plainly

These are real limitations, not formalities. You should understand them before consenting.

• No physical examination. Your clinician cannot examine you, listen to your heart or lungs, or palpate anything. Conditions that would be caught on physical exam can be missed.
• The evaluation depends on what you report. If your history is incomplete or inaccurate, the clinical conclusion drawn from it may be wrong, and treatment based on it may be unsafe.
• Some conditions cannot be managed remotely. Your clinician may determine that you need in-person evaluation, laboratory work, or imaging before any treatment decision can be made.
• Technology can fail. Delays, outages, or transmission problems can interrupt care or postpone a decision.
• Electronic communication carries privacy risk. We use secure systems, but no electronic transmission can be guaranteed completely private.
• This is not emergency care. Telehealth cannot respond to an emergency. Call 911 or go to an emergency room.

Your rights

• You may withhold or withdraw consent to telehealth at any time without affecting your right to future care.
• You may request in-person care instead, though this practice provides telehealth only and would refer you elsewhere.
• Your health information is protected the same way it would be for an in-person visit.
• You may ask who is present or participating in your visit at any time.
• You have a right to a copy of your medical record.

Location and licensure

You must be physically located in a state where your clinician holds an active license at the time of your visit. You agree to tell us accurately where you are located, and to tell us if you move, because it determines who can legally treat you.

No guaranteed outcome

You understand that this consent does not guarantee any particular result, and specifically does not guarantee that you will be prescribed medication. Your clinician may determine that treatment is not clinically appropriate for you. If that happens, your fee is refunded under the Refund and Cancellation Policy.

By agreeing, you confirm

• You have read and understood this consent.
• You have had the opportunity to ask questions about it.
• You are at least 18 years old and are seeking care for yourself.
• You consent to receive care from PWS-TX PLLC by telehealth.

Questions before you consent: contact us. We would rather answer them first.