Telemedicine consent
I understand that telemedicine uses electronic communications to provide healthcare when the patient and clinician are in different locations. The clinician may decide that an in-person examination or emergency referral is required.
I understand the limits of remote assessment, the possibility of technical interruption, and the privacy risks inherent in electronic communication. I may ask questions, decline the consultation, or withdraw consent for future consultations.
This service is not an emergency service. If I have severe breathing difficulty, chest pain, stroke symptoms, uncontrolled bleeding, loss of consciousness, a severe allergic reaction, or an immediate risk of self-harm, I will seek emergency care.
I authorize the hospital to use the information collected for treatment, care coordination, billing where applicable, safety, and legally required reporting, subject to the hospital privacy notice and retention policy.
