Telehealth Services Medical Records
I understand and have been explained my rights and consent to telehealth services which include remote monitoring on a routine basis. I additionally have been provided basic information about the benefits of telehealth services and understand that these services may be recorded.
I have the right to refuse to participate in services delivered via telehealth and have been made aware of alternatives and potential drawbacks compared to face to face consultations.
I have been made aware of the role of the practitioner at the distant site, as well as qualified professional staff at the originating site who are going to be responsible for follow up care.
I have been explained and made aware of the location of distant sites and all questions regarding equipment and technology.
I have the right to request appropriately trained staff immediately available while receiving the telehealth service to attend emergencies or other needs.
I have the right to be informed of all parties who will be present at each end of the telehealth transmission.
I have the right to select another provider and be notified that by selecting another provider, there could be a delay in service and the potential need to travel for a face to face visit .