• Telehealth Psychotherapy Consent Form

  • Psychological Services: Psychotherapy practices and services are varying according to specific conditions of patients. Because of that, there are many techniques that are applied by the professionals to be helpful for the patient. Psychotherapy session durations can be varied with respect to the problems. The patient accepts that telehealth psychotherapy practices may include mental health evaluation, consultation and planned therapy sessions with video and audio connection.

    Risks: Sessions have both benefits and risks because the therapy mainly involves various parts of patients' lives. Patients may experience some undesirable feelings before, during and after the sessions. On the other hand, the therapy will provide solutions to problems and uncomfortable situations. Hence, the patient accepts that he/she can benefit from telehealth psychotherapy sessions; however, the result is not certain and cannot be guaranteed.

    Confidentiality: Personal information of patients will be kept private and that is an obligation by the governmental laws. The health care provider will not responsible for any exposure caused by the location or network connected by the patient before, during and after telehealth psychotherapy sessions.

    Rights: The patient can withdraw or withhold the consent at any time and this will not affect the future practices and treatment.

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  • You can print the form with "Print Form" before the submission in order to get a hard copy for your records.

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