1. Telehealth Counseling
Telehealth counseling allows therapists, clinicians and specialists to provide a diagnosis, consultation and treatment using videoconference technology via telephone or computer.
The purpose of Telehealth Counseling Consent Form is to get permissions from patients in order to participate into telehealth counseling services.
Audio and video recordings of patients during appointments/online visits will be kept private. Medical and personal information of patients are protected by the state and governmental laws.
4. Risks and Benefits
Telehealth counseling aims to provide a complete treatment to patients. It is considered and supported by researches that online counseling is an effective way in treatment of various disorders, personal issues and problems. On the other hand, it may not be beneficial and there is no guarantee that the counseling will be effective for patients.
Patients agree that they are responsible for paying any additional cost or payment that their insurance providers do not cover.
Patients can withdraw and withhold this consent at any time and they can end the treatment any time they would like to. Any action of patients will not affect the future treatment of or accessibility to counseling services.
By signing this form, I agree that I know and understand the information above. My questions were answered completely during the discussion with the therapist, clinician or specialist. I hereby give my consent to participate into telehealth counseling services provided by the healthcare organization.