Purpose
The purpose of this Telebehavioral Health Informed Consent Form is to get permission and consent of patients in order to participate in telebehavioral health services and inform them about the services, risks, benefits, and requirements.
Telebehavioral Health
Telebehavioral health provides complete behavioral health services using interactive videoconference visits. It enables getting treatment without physically visiting the doctor's office.
Security and Confidentiality
Technologies used for telebehavioral health services have security protocols and protect the patient's personal and medical information while transferring via electronic channels.
Benefits and Limitations
Telebehavioral health services can be reached by patients via a personal computer, telephone, or tablet. This eliminates the requirement of physical appointments between the patient and the doctor. On the other hand, the services cannot be as effective as in physical visits. The quality and effectiveness of the doctor's visits depend on various factors such as internet speed, device model, and video resolution in telebehavioral health services.
Rights
Patients can decline to get telebehavioral health services at any time and this does not affect future treatment. Patients can ask any questions regarding telebehavioral health services before, during, or after they give their consent.
By signing this form, patients confirm that they agree:
- that the information they have given in this form is accurate and complete.
- to participate in telebehavioral health services and give their permission to the healthcare professionals, doctors, and specialists to evaluate their medical conditions.
- that they have understood all the terms and accept they are the responsible party to protect their credentials.
- that they have been given an opportunity to ask their questions regarding the services and they have been answered completely.