Telehealth Informed Consent

Introduction

This Telehealth Informed Consent (“Consent”) describes your rights and responsibilities when receiving telehealth services through Marron Health. By using our telehealth services, you acknowledge that you have read, understand, and agree to the terms of this Consent.

Telehealth involves the use of electronic communications, information technology, and other means to enable healthcare providers and patients who are not in the same physical location to communicate for the purpose of providing healthcare services.

Nature of Telehealth Services

Through Marron Health, you will have access to licensed healthcare providers who will evaluate your health condition through telehealth technologies, which may include:

• Asynchronous (store-and-forward) communication, including secure messaging and questionnaires
• Synchronous (real-time) audio and/or video consultations
• Review of medical records, photographs, and other health information you provide
• Remote monitoring of health data

Benefits of Telehealth

Telehealth offers several potential benefits, including:

• Improved access to healthcare by eliminating geographic and transportation barriers
• Convenience of receiving care from your home or other location
• Reduced exposure to potentially contagious patients in waiting rooms
• More efficient evaluation and management of your health condition
• Access to specialists who may not be available in your area
• Flexible scheduling options

Risks and Limitations of Telehealth

As with any medical service, there are potential risks associated with telehealth, including but not limited to:

• Technology Limitations: The information transmitted may not be sufficient to allow for appropriate medical decision-making by the provider. Technical difficulties may interrupt or prevent your consultation.
• Delays: Delays in evaluation and treatment could occur due to deficiencies or failures of equipment, connectivity issues, or other technical problems.
• Security: Despite reasonable efforts to protect the privacy of your health information, security protocols could fail, potentially resulting in a breach of privacy.
• Diagnostic Limitations: The inability to conduct a physical examination may limit the provider's ability to diagnose your condition.
• Emergency Situations: Telehealth may not be appropriate for emergency situations. If you experience a medical emergency, you should call 911 or go to the nearest emergency room.

In rare cases, information transmitted may be insufficient, leading the provider to recommend an in-person visit or to a different healthcare provider.

Your Rights

You have the right to:

• Withhold or withdraw your consent to telehealth services at any time without affecting your right to future care or treatment
• Access your medical information and copies of your medical records
• Expect that your healthcare provider will inform you of any other parties who will be present during your telehealth consultation
• Request that any participant be removed from the telehealth consultation
• Receive information about the limitations of telehealth, including the potential need for in-person follow-up care
• Be informed of alternatives to telehealth consultation

Your Responsibilities

By consenting to telehealth services, you agree to:

• Provide accurate and complete information about your medical history, current health condition, medications, and allergies
• Inform your provider if you have any pre-existing conditions or are taking any medications that may affect your treatment
• Use a secure, private location with a reliable internet connection for your telehealth visits
• Ensure you are in a state where our providers are licensed to practice during your consultation
• Follow the treatment plan prescribed by your healthcare provider
• Report any side effects, adverse reactions, or changes in your condition promptly
• Seek emergency care when appropriate and not rely solely on telehealth services for emergencies

Prescriptions

If your healthcare provider determines that prescription medication is appropriate for your condition, they may electronically prescribe medication to a pharmacy of your choice. You understand and agree that:

• Not all patients will qualify for prescription medications
• The decision to prescribe medication is made solely by the treating healthcare provider
• You will use prescribed medications only as directed and not share them with others
• You will report any side effects or concerns about your medication to your provider
• Certain medications, including controlled substances, may not be prescribed via telehealth in accordance with state and federal law

Privacy and Confidentiality

Your telehealth consultations will be conducted using secure, HIPAA-compliant technology. We maintain administrative, physical, and technical safeguards to protect your health information. However, as with any electronic communication, there is a risk that security measures may be compromised.

Your health information will be used and disclosed in accordance with our Notice of Privacy Practices, which is available on our website.

Emergencies

Examples of medical emergencies include, but are not limited to: chest pain, difficulty breathing, severe allergic reactions, thoughts of harming yourself or others, loss of consciousness, severe bleeding, or signs of stroke.

Recording

Telehealth consultations may be recorded for quality assurance, training, or documentation purposes. You will be notified if your session is being recorded. You agree not to record any telehealth consultation without the prior written consent of all participants.

Consent

By using Marron Health's telehealth services, you acknowledge and agree that:

• You have read and understand this Telehealth Informed Consent
• You have had the opportunity to ask questions and have them answered to your satisfaction
• You voluntarily consent to receive healthcare services via telehealth
• You understand the risks, benefits, and limitations of telehealth
• You understand that you may withdraw this consent at any time

Contact Information

If you have questions about this Consent or our telehealth services, please contact us: