Telehealth Informed Consent
Last updated: [Date to be added]
PLACEHOLDER: This document requires legal review before use. The content below is a template structure only and should not be considered legally binding.
1. Introduction to Telehealth
Telehealth involves the use of electronic communications to enable healthcare providers to deliver medical services remotely. This may include consultation, diagnosis, treatment recommendations, and prescription services conducted via video conferencing, phone calls, secure messaging, and other digital platforms.
This consent form explains the nature, benefits, risks, and limitations of telehealth services provided by Livevital Medical. By using our telehealth services, you acknowledge that you have read, understand, and agree to the terms outlined in this document.
2. Nature of Telehealth Services
Livevital Medical provides telehealth services for health optimization, hormone therapy, weight management, peptide therapy, and longevity medicine. Our services include virtual consultations, review of lab results, prescription management, and ongoing care coordination.
Telehealth consultations are conducted via secure video conferencing technology. You will interact with a licensed healthcare provider who will evaluate your condition, discuss treatment options, and provide medical recommendations.
3. Benefits of Telehealth
Convenience: Access medical care from the comfort of your home without travel.
Accessibility: Receive care regardless of geographic location where telehealth is permitted.
Flexibility: Schedule appointments that fit your lifestyle.
Continuity: Maintain regular communication with your healthcare provider.
Privacy: Conduct sensitive health discussions in your private environment.
4. Risks and Limitations
Technical Issues: Telehealth relies on technology that may experience interruptions, delays, or failures. Poor internet connection or equipment malfunction may affect the quality of your consultation.
Limitations of Remote Evaluation: Physical examinations are limited in a telehealth setting. Your provider may not be able to detect conditions that would be apparent in an in-person visit.
Security Risks: Despite our use of encrypted, HIPAA-compliant technology, there is a small risk that electronic communications could be intercepted or compromised.
Not Suitable for Emergencies: Telehealth services are not appropriate for emergency medical situations. If you experience a medical emergency, call 911 or go to the nearest emergency room.
Prescribing Limitations: Certain medications may not be prescribed via telehealth, and some conditions may require in-person evaluation before treatment.
5. Your Responsibilities
Accurate Information: You agree to provide accurate and complete medical history, current medications, allergies, and other relevant health information.
Suitable Environment: Ensure you are in a private, quiet location with adequate lighting and a stable internet connection for video consultations.
Active Participation: Engage actively in your care, ask questions, and follow your treatment plan as prescribed.
Emergency Protocol: In case of emergency, you will seek immediate in-person care rather than relying on telehealth services.
Follow-Up Care: Attend scheduled follow-up appointments and communicate any changes in your condition.
6. Privacy and Confidentiality
All telehealth consultations are conducted using HIPAA-compliant technology with end-to-end encryption. Your health information is protected under federal and state privacy laws.
We will not record telehealth sessions without your explicit consent. Medical notes and records from telehealth visits are maintained securely and treated with the same confidentiality as in-person visits.
You are responsible for ensuring your environment is private during telehealth consultations.
7. Rights Regarding Telehealth
You have the right to request an in-person visit instead of telehealth if you prefer.
You may withdraw your consent for telehealth services at any time.
You may ask questions about the telehealth process at any time.
You have the right to know the identity and qualifications of your healthcare provider.
Your consent to telehealth does not waive any of your rights as a patient.
8. Technical Requirements
To participate in telehealth visits, you will need:
A device with a camera and microphone (smartphone, tablet, or computer)
A stable internet connection (broadband recommended)
A private, quiet location
Updated web browser or our designated telehealth application
Our team can provide technical support if you experience difficulties connecting.
9. Consent Statement
By using Livevital Medical's telehealth services, I acknowledge and agree to the following:
I have read and understand the information provided about telehealth services.
I understand the potential benefits, risks, and limitations of telehealth.
I agree to participate in telehealth consultations as part of my medical care.
I understand that I may withdraw my consent at any time.
I understand that telehealth is not appropriate for emergency situations.
I will provide accurate medical information to my healthcare provider.
I consent to the electronic transmission of my health information for treatment purposes.
Questions About This Policy?
If you have any questions about this document, please contact us at:
Email: legal@livevital.com
Phone: (801) 555-0123
Address: [Business Address - To Be Added]