Consent for Telehealth Services Sample Contracts

Brighter Futures Counseling, PLLC
Consent for Telehealth Services • March 23rd, 2020

Thank you for choosing Brighter Futures Counseling, PLLC for your ongoing counseling and therapy needs. This document contains important information about our telehealth services. Please read this carefully and feel free to ask any questions that you may have. You will be asked to sign this document at the end, signifying your consent for telehealth services. Please note that signing this agreement does not negate or change any of the policies you formally agreed to in our Professional Service Agreement you signed at intake.

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CONSENT FOR TELEHEALTH SERVICES AND TREATMENT
Consent for Telehealth Services • March 23rd, 2020

Thank you for choosing us for your telehealth care. Patients and families are essential participants in health care, and we want you to understand your rights and responsibilities while receiving care from us. If you have any questions about this form, please ask your provider. If you are a guardian/legally-authorized representative of a patient, please read this agreement with the understanding that “I” and “me” means the patient.

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