Telehealth Consent

SHREVEPORT DIRECT CARE, LLC
Telehealth Informed Consent

Shreveport Direct Care

Telehealth involves the use of electronic communications to enable healthcare providers at Shreveport Direct Care to deliver services to patients who are not physically present at the same location. These services include medical consultations, diagnosis, treatment, and education.

Understanding Telehealth

Telehealth services are provided using secure electronic communication platforms, including video conferencing and patient portals. While these platforms are designed to be secure, there are inherent risks associated with the electronic transmission of personal health information.

Potential Risks:

  • Breaches of privacy due to unauthorized access.

  • Transmission errors or technical difficulties.

  • Limitations in the ability to perform comprehensive physical assessments.

Patient Acknowledgment

By signing this consent form, I acknowledge and agree to the following:

  1. Nature of Telehealth Services:

    • Telehealth services involve the exchange of medical information in a virtual format.

    • I may opt-out of telehealth services at any time, and this decision will not affect my ability to receive future care at Shreveport Direct Care.

  2. Privacy and Security:

    • While every effort is made to ensure the confidentiality of my health information, there are risks associated with the electronic transmission of information.

    • I will take precautions to ensure my own privacy, such as using a secure connection and location during telehealth visits.

  3. Scope of Care:

    • Telehealth services may be limited in scope compared to in-person visits.

    • I agree to follow up with in-person visits or other diagnostic testing as recommended by my provider.

  4. Eligibility:

    • Telehealth services are available only to patients who are physically present in Louisiana at the time of the appointment.

  5. Emergency Situations:

    • I will not use telehealth for emergencies or urgent medical needs. Instead, I will contact emergency services or visit the nearest emergency room.