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Telehealth Consent Form

Get informed consent from patients online. Collect legally binding electronic signatures. Easy to customize for your practice. HIPAA compliance option.

Telehealth Consent Form

Please read the following information carefully and sign below to indicate your understanding and agreement.

Email*

Introduction*

Consent to Telehealth*

I understand that telehealth involves the use of electronic communications to enable healthcare providers at different locations to share individual patient medical information for the purpose of improving patient care. I understand that telehealth may involve the communication of my medical information, both orally and visually, to healthcare providers who may be located in other areas, including outside of the United States. I understand that I have the right to withhold or withdraw my consent to the use of telehealth in the course of my care at any time, without affecting my right to future care or treatment.

Consent to Electronic Signature*

I understand that by typing my name below, I am electronically signing this document and agreeing to the terms and conditions outlined above.

Patient Name*

Date*

Select date

Description:Get informed consent from patients online with our Telehealth Consent Form. Customize the form to fit your practice's needs and collect legally binding electronic signatures. Our form is HIPAA compliant, ensuring the privacy and security of your patients' information.

Telehealth has become an essential tool for healthcare providers to connect with their patients remotely. Our Telehealth Consent Form makes it easy for you to obtain informed consent from your patients before conducting telehealth appointments. The form is fully customizable, allowing you to tailor it to your practice's specific needs. With our form, you can collect legally binding electronic signatures, making the process more efficient and secure. Additionally, our form is HIPAA compliant, ensuring that your patients' information is kept private and secure. Use our Telehealth Consent Form to streamline your telehealth appointments and provide your patients with the best possible care.

Patient Name*

Date of Birth*

Address*

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