Telehealth Informed Consent
Last updated: August 14, 2026
Nature of Telehealth
Telehealth involves the use of electronic communications to enable a licensed provider to evaluate and treat you without an in-person visit.
Risks of Telehealth
Potential risks include:
- Technical failures
- Incomplete information due to electronic communication
- Delays in evaluation or treatment
- In rare cases, information transmitted may be insufficient for sound clinical decision-making
Benefits of Telehealth
Benefits may include:
- Improved access to healthcare providers
- Convenience and flexibility
- Reduced travel time
Patient Responsibilities
You agree to:
- Provide accurate medical information
- Inform providers of any changes in your condition
- Seek emergency care when appropriate
Consent to Treatment
By proceeding, you acknowledge that you have read and understood this notice and consent to receive care via telehealth. You may withdraw your consent at any time.
Telehealth is not a substitute for emergency care. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room.
Contact Information
Adapt Your Life Academy