Telehealth Consent

Informed Consent for Telehealth Services

By scheduling and participating in telehealth consultations with Cadence Health LLC, you acknowledge and consent to the following:

Definition of Telehealth

Telehealth involves the use of electronic communications to enable healthcare providers to provide medical services to patients at different locations. This may include:

• Live video conferencing
• Store-and-forward imaging and data transmission
• Remote patient monitoring
• Secure messaging within our patient portal

Benefits of Telehealth

• Convenience: Access to care from your home or preferred location
• Reduced Travel: No need to travel to a physical clinic
• Continuity: Easier follow-up appointments and ongoing care
• Safety: Reduced exposure to contagious illnesses
• Access: Healthcare access regardless of geographic location

Limitations of Telehealth

I understand that telehealth has certain limitations:

• Physical examination is limited to what can be observed through video
• Certain diagnostic procedures cannot be performed remotely
• Technology failures may interrupt or prevent consultation
• Emergency situations cannot be adequately addressed via telehealth

Technology Requirements and Responsibilities

Patient Responsibilities

• Ensure reliable internet connection and appropriate device
• Test technology in advance of appointments
• Provide a private, well-lit location for consultations
• Have your photo ID available for identity verification
• Inform us immediately of any technical problems

Provider Responsibilities

• Use secure, HIPAA-compliant telehealth platforms
• Verify patient identity before each consultation
• Maintain professional standards equivalent to in-person care
• Document all telehealth encounters appropriately

Privacy and Security

We use secure, encrypted telehealth platforms to protect your privacy. However, you acknowledge:

• No technology is 100% secure
• You are responsible for maintaining privacy on your end (private location, secure device)
• Others may be present during your consultation only with your explicit permission
• Consultations may be recorded for quality assurance with your consent

Emergency Situations

Prescribing Limitations

Regarding prescription medications:

• Prescriptions are based on telehealth evaluation and your medical history
• Certain controlled substances may require in-person evaluation
• You may be required to visit a laboratory or local clinic for tests
• We reserve the right to require in-person evaluation when medically necessary

Quality of Care

We strive to provide the same quality of care via telehealth as in traditional face-to-face consultations. However, I understand:

• The provider may determine that in-person evaluation is necessary
• Telehealth consultation may not be sufficient for comprehensive diagnosis
• Additional testing or specialist referral may be recommended

Scheduling and Cancellation

• Appointments are scheduled through our secure patient portal or by phone
• You will receive appointment confirmations and reminders
• Please test your technology 15 minutes before your appointment
• Cancellations should be made at least 24 hours in advance

Payment and Insurance

• Telehealth visits are billed the same as in-person consultations
• Payment is due at the time of service
• You are responsible for verifying insurance coverage for telehealth services
• Some insurance plans may not cover telehealth consultations

State Licensing and Jurisdiction

Important legal considerations:

• Our physicians are licensed in Minnesota and provide telehealth services exclusively to Minnesota residents
• You must be physically located in Minnesota during consultation
• Interstate practice of medicine is regulated by state medical boards
• Services are subject to Minnesota state laws and regulations

Your Rights

As a telehealth patient, you have the right to:

• Receive the same professional standards of care as in-person visits
• Privacy and confidentiality of your medical information
• Access your medical records according to applicable laws
• Informed consent before any treatment
• Discontinue telehealth services at any time

Consent to Treatment

By using our telehealth services, you:

• Consent to receive medical care via telehealth technology
• Understand the benefits and limitations outlined above
• Acknowledge that results cannot be guaranteed
• Accept responsibility for your role in the telehealth process
• Agree to follow treatment recommendations and ask questions when unclear

Electronic Consent Process

During your patient registration, you will be asked to electronically sign this consent form, confirming:

• You have read and understand this information
• Your questions about telehealth have been answered
• You voluntarily consent to telehealth services
• You understand you may withdraw this consent at any time