Common use of Consent for Telehealth Services Clause in Contracts

Consent for Telehealth Services. Telehealth involves transmission of video, photographs, and/or details of my medical record such as x-rays and test results (collectively, “Data”). I understand that: • I will be informed of any other people who are present at the Providers’ end of the telehealth encounter, and have the right to exclude anyone. • Except as modified or waived by Executive Order or other action taken by Federal or State authorities, all confidentiality protections required by law or regulation will apply to my care. • I have the right to refuse or stop participation in telehealth services at any time and request alternate services such as an in-person appointment. However, I understand that equivalent in-person services might not be available at the same location or time as telehealth services. • If I do not want to receive health care services by telehealth, it will not affect my right to future care or treatment, or any insurance/ program benefits to which I would otherwise be entitled. • If an emergency occurs during a telehealth encounter at a hospital or clinic, health care personnel at my location will manage the emergency. If an emergency occurs during a telehealth encounter when I am at a non-health-care site, I should call 911 and stay on the video connection (if applicable) until help arrives.

Consent for Telehealth Services. Telehealth involves transmission of video, photographs, and/or details of my medical record such as x-rays and test results (collectively, “Data”). All Data is sent by secure electronic means to the Providers to facilitate the medical service being performed. I understand that: •  I will be informed of any other people who are present at the Providers’ either end of the telehealth encounter, and have the right to exclude anyoneanyone from either location. • Except as modified or waived by Executive Order or other action taken by Federal or State authorities, all  All confidentiality protections required by law or regulation will apply to my care. •  I have the right to refuse or stop participation in telehealth services at any time and request alternate services such as an in-person appointment. However, I understand that equivalent in-person services might not be available at the same location or time as telehealth services. •  If I do not want to receive health care services by telehealth, it will not affect my right to future care or treatment, or any insurance/ program benefits to which I would otherwise be entitled. •  If an emergency occurs during a telehealth encounter at a hospital or clinic, health care personnel at my location will manage the emergency. If an emergency occurs during a telehealth encounter when I am at a non-health-care site, I should call 911 and stay on the video connection (if applicable) until help arrives.