Telehealth Informed Consent
This page is starter language adapted from common templates. It is not legal advice and must be reviewed and finalized by qualified counsel before ojava health begins providing services.
This document describes what you can expect from a telehealth visit with an ojava health clinician, including its benefits and limitations. By scheduling and participating in a telehealth visit, you acknowledge and agree to the terms below.
What telehealth is
Telehealth uses secure video, audio, and electronic messaging to deliver care without requiring you to visit an office in person. Your provider may take a history, review symptoms, evaluate labs, and prescribe medications when clinically appropriate.
Benefits
- Care from licensed clinicians without travel or waiting rooms.
- Ongoing access to your provider for follow-up and adjustments.
- Privacy and convenience.
Limitations and risks
- Telehealth cannot fully substitute for an in-person physical examination. Some conditions cannot be diagnosed or treated remotely.
- Technology problems (e.g., poor connection) may interrupt or delay a visit.
- Although we use HIPAA-compliant systems, no electronic communication can be guaranteed to be 100% secure.
- Your provider may determine that an in-person visit, lab test, or emergency care is necessary, in which case they will not prescribe through telehealth.
Emergencies
Telehealth is not for emergencies. If you are experiencing a medical emergency, call 911 or go to your nearest emergency room.
Your rights
- You may decline or stop a telehealth visit at any time.
- You may request an in-person referral if telehealth is not appropriate for your needs.
- You may request a copy of your medical record.
State licensing
Your provider must be licensed in the state where you are located at the time of the visit. Some treatments are subject to state-specific restrictions. We will tell you upfront if a treatment is not available in your state.
Consent
By proceeding with a telehealth visit, you confirm that you have read this document, that you understand the benefits and limitations of telehealth, and that you consent to receive care through telehealth.