Telehealth Consultation Audit Checklist Form
Complete this checklist to evaluate the quality and compliance of the telehealth consultation.
Was the patient's identity verified at the start of the consultation?
*
Yes
No
Not Applicable
Did the clinician introduce themselves and explain their role?
*
Yes
No
Not Applicable
Was the purpose and process of the telehealth consultation explained to the patient?
*
Yes
No
Not Applicable
How would you rate the clarity and effectiveness of communication during the consultation?
*
1
2
3
4
5
Were privacy and confidentiality measures discussed and maintained?
*
Yes
No
Not Applicable
Technical quality of the consultation (audio/video connection):
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Clinical thoroughness and appropriateness of history-taking and examination:
*
Insufficient
1
2
3
4
Comprehensive
5
1 is Insufficient, 5 is Comprehensive
Was the clinical decision-making process clear and evidence-based?
*
Yes
No
Partially
Documentation compliance (notes, recommendations, follow-up):
*
Rows
Complete
Partial
Missing
Consultation notes
1
2
3
Recommendations
4
5
6
Follow-up plan
7
8
9
Overall quality and compliance of the telehealth consultation:
*
Poor
1
2
3
4
Excellent
5
1 is Poor, 5 is Excellent
Submit Audit
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