Telehealth Informed Consent

I understand that my care may be delivered via telehealth using secure electronic communication technology.

I acknowledge:

• Telehealth may include video, audio, or electronic communication.

• There are potential risks to privacy despite reasonable safeguards.

• Technology failures may occur.

• I may withdraw consent to telehealth at any time.

• I may request in-person care when available.

• Telehealth is not appropriate for emergency situations.

I agree to provide accurate information regarding my physical location at each visit to allow emergency response if necessary.

I understand that the standard of care is the same as in-person medical care.