Telemedicine Disclaimer

I am finding it difficult to to construct a Telemedicine Disclaimer for the patient to consent to. Is there anyone willing to share and post on this thread? I would appreciate any help.

Attached is what we use at Lincoln Pediatric Group. We have done this 2 different ways as we’re trying to figure out the best way. We email this to them and have them sign and email back. We’ve also used docusign website.

Telehealth Consent updated.pdf (353.1 KB)

This is the we have to use for Georgia Medicaid.
Telemedicine Consent Form.pdf (66.7 KB)

Thank you and great video post this week!

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You re-posted the same pdf I shared.

Oops, thank you! Posted the right one now.

We are using and they have temporarily disabled the consent feature citing that the requirement has been lifted during this National State of Emergency. They provided a link to their “general consent” that you could use as a template to make your own. I attached it here. Default teleconsent document.pdf (27.1 KB)