Telehealth Informed Consent

What telehealth is

Telehealth involves the use of secure video and audio communications to deliver psychiatric evaluation, medication management, and follow-up care remotely, without an in-person visit.

Potential benefits

• Access to specialty psychiatric care without travel.
• Greater scheduling flexibility.
• Care from the privacy of your own environment.
• Continuity of care when in-person visits are not practical.

Potential risks and limitations

• Technology failures (dropped connections, poor audio or video) may interrupt or delay care.
• Certain clinical findings that can be assessed in person may not be assessable by video.
• Despite reasonable security measures, no electronic transmission can be guaranteed fully confidential.
• If a clinical situation exceeds what can safely be managed by telehealth, you may be referred to in-person care or an emergency setting.

Technology requirements

• A private, quiet space where you will not be interrupted.
• A stable internet connection and a working camera and microphone.
• A device that supports the secure telehealth platform we use.
• You are expected to be located in a state where the provider is licensed to practice at the time of the appointment.

Emergency protocol

Telehealth is not appropriate for psychiatric emergencies. If you are experiencing a life-threatening emergency or a crisis in which you or someone else is in immediate danger:

• Call 911 or go to your nearest emergency room.
• Call or text 988 to reach the Suicide & Crisis Lifeline.

At the start of each telehealth session, you may be asked to confirm your current physical location and the phone number where you can be reached in the event the connection is lost.

Confidentiality

Your telehealth visit is subject to the same confidentiality protections as an in-person visit, including HIPAA and applicable state laws. Confidentiality may be limited by mandatory reporting requirements (for example, suspected abuse, or threats of imminent harm to self or others), court orders, or your written authorization to release information.

Please take reasonable steps on your end to protect confidentiality, including using a private location and not recording sessions without prior discussion.

Alternatives to telehealth

You have the right to decline telehealth and request in-person care where available, or to seek care from another provider. You may withdraw consent to telehealth at any time, without affecting your right to future care.

Questions

Questions about this consent can be directed to hello@therootcausenp.com.