Telehealth Consent

This page explains how telehealth works at Rose Hope Psychiatry and what you agree to when using virtual sessions. By joining a video or phone visit, you acknowledge that you have read and understand the information below.

1. What Telehealth Is

Telehealth allows you to meet with your provider through secure video or telephone technology. Telehealth appointments follow the same standards of care as in-person visits and allow you to receive care from a private location that is appropriate for your appointment.

2. Telehealth Eligibility

Telehealth services are available only to patients who are physically located in a state where our providers are licensed and authorized to practice at the time of the appointment. Patients must provide their current physical location at the beginning of each telehealth visit. If you are located outside an authorized state, your appointment may need to be rescheduled.

Telehealth services for minors are available only with the participation or consent of a parent or legal guardian, as required by applicable law.

3. What Telehealth Includes

Telehealth services may include:

• Video appointments
• Telephone appointments, when appropriate
• Secure messaging for limited clinical questions
• Secure sharing of medical records and treatment information through approved platforms

Your provider will determine the most appropriate method of communication based on your clinical needs.

4. Technology Requirements

To participate in a telehealth appointment, you should have:

• A smartphone, tablet, or computer with a working camera and microphone
• A reliable internet connection
• Access to the approved telehealth platform provided by our office
• A private, quiet location where your conversation cannot be overheard

Please test your device and internet connection before your appointment whenever possible.

5. Limits of Telehealth

Although telehealth offers convenient access to care, it also has limitations.

• Internet or technology issues may interrupt a session.
• Video may not provide all information needed for a complete clinical assessment.
• Some medical or psychiatric concerns may require an in-person evaluation.
• You are responsible for participating from a private location to help protect your personal health information.

If telehealth is not appropriate for your needs, your provider will recommend an in-person appointment or another suitable option.

6. If the Video Connection Fails

If your video connection is interrupted during your appointment, we will make reasonable efforts to reconnect. If video cannot be restored, your provider may continue the visit by telephone when clinically appropriate or reschedule the appointment if necessary.

7. Your Responsibilities

By participating in telehealth services, you agree to:

• Join your appointment from a quiet, private location.
• Use a reliable device with working audio and video capabilities.
• Keep your meeting links and login information secure.
• Not record the appointment without prior permission.
• Follow your provider’s instructions regarding your care.
• Be physically located in a state where your provider is authorized to provide telehealth services.
• Not drive or operate a motor vehicle during your telehealth appointment. If you are driving when the appointment begins, your provider may end or reschedule the visit.

8. Emergencies

Telehealth is not intended for medical or psychiatric emergencies.

If you believe you are experiencing an emergency, are in immediate danger, or are considering harming yourself or others, call 911 immediately or go to the nearest emergency department.

For crisis support, you may also contact:

• Suicide Prevention Lifeline: 1-800-273-8255
• Crisis Support: Call or Text 988

9. Privacy and Security

We use secure technology designed to protect your personal health information and comply with applicable privacy laws. While we take reasonable steps to safeguard your information, no electronic communication system can guarantee complete security.

Your privacy rights during telehealth appointments are the same as those for in-person care. Please review our HIPAA Privacy Policy and Notice of Privacy Practices for additional information.

10. Sharing of Information

Your health information may be used or disclosed only as permitted by applicable law for:

• Treatment
• Payment
• Health care operations
• Legal or regulatory requirements
• Other purposes authorized by you in writing

We limit disclosures to the minimum information necessary whenever possible.

11. Risks and Benefits

Benefits

• Convenient access to care
• Reduced travel time
• Greater scheduling flexibility
• Continuity of care when travel or weather prevents in-person visits

Potential Risks

• Internet or technology failures
• Audio or video quality issues
• Privacy risks if you participate from a public or non-private location
• The possibility that an in-person visit may still be necessary

12. Your Right to Stop Telehealth

You may choose to stop using telehealth services at any time. You may request an in-person appointment whenever available, and your provider may recommend in-person care if it is clinically appropriate.

13. Consent

By participating in a telehealth appointment, you acknowledge that:

• You have read and understand this Telehealth Policy.
• You have had the opportunity to ask questions.
• You consent to receive care through telehealth services.
• You understand the benefits, risks, and limitations of telehealth.

If you have questions about telehealth services, please contact our office before your appointment.