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Telehealth Consent Forms (English and Spanish)

By Reid Horton | Get Started, Sample Forms and Guidelines | Comments are Closed | 15 January, 2021 | 0

Telemedicine involves the use of audio, video or other electronic communications to interact with you, consult with your healthcare provider and/or review your medical information for the purpose of diagnosis, therapy, follow-up and/or education. During your telemedicine consultation, details of your medical history and personal health information may be discussed with other health professionals through the use of interactive video, audio and telecommunications technology. Additionally, a physical examination of you may take place and video, audio, and/or photo recordings may be taken.

DOWNLAD ENGLISH
DOWNLAD SPANISH
Telehealth Consent Forms (English and Spanish)
INFORMED CONSENT FORM
SAMPLE CONSENT (COVID)
INFORMED CONSENT (COVID)
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The California Telehealth Resource Center (CTRC) and all resources and activities produced or supported by the CTRC are made possible by grant number U1UTH42520-01-01 from the Office for the Advancement of Telehealth, Health Resources and Services Administration, DHHS. This information or content and conclusions are those of the CTRC and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS, or the U.S. Government. The information and tools presented on the California Telehealth Resource Center’s (CTRC) website are intended for general information purposes only and are not intended or implied to be a substitute for professional legal and billing advice. We recommend discussing billing and legal decisions with your organization’s compliance officer to ensure agreement or consulting with an attorney regarding any legal issue. All materials are strictly for informational and educational purposes only.
  • About CTRC
    • Our Mission
    • How We Do it
    • Our Team
    • Our Advisory Board
  • Tools and Resources
    • For Providers
    • Payment & Regulation
      • Digital Health Payment Guide
        • Digital Health Services Payment Guide Door 1
        • CTRC Digital Payment Guide – Door 2
    • Rural Health
    • Artificial Intelligence
    • Remote Physiological Monitoring
    • School-Based Telehealth
    • Patient Resources
    • Videos
    • Sustainability Calculator
    • Equipment Selection Tool
    • CTRC Blogs
    • CTRC Newsletters
  • Training and Education
    • CTRC Telehealth Online Courses
    • TeleHealth Course Finder
    • National Consortium of TRCs
    • Telehealth Summit
  • Events Calendar
  • Contact Us
California Telehealth Resource Center