Clinical informed consent
Telehealth Informed Consent
The benefits, limitations, privacy considerations, alternatives, and patient responsibilities involved in receiving care remotely.
Contents9 sections
1. What telehealth means
#Telehealth uses video, audio, secure messaging, remote-monitoring tools, electronic records, and other technology to allow a patient and licensed health professional in different locations to communicate and exchange health information.
Services may include history-taking, consultation, diagnosis, treatment recommendations, prescribing when appropriate, care coordination, review of laboratory or wearable data, and referral for in-person care.
2. Provider identity and your location
#Clinical care is provided by a Partner Medical Practice and its licensed professionals, not by Matter Labs LLC or the Everdawn non-clinical services organization. Your provider and treating practice will disclose their identities and professional credentials as required.
You agree to accurately disclose the state and physical location where you are present for each clinical interaction. Care may be unavailable if your provider is not licensed or legally authorized to treat a patient in that location.
3. Potential benefits
#Potential benefits include more convenient access, improved continuity, faster exchange of information, reduced travel, greater participation in care, and the ability to review longitudinal data remotely. Results vary, and no outcome is guaranteed.
4. Risks and limitations
#Telehealth may involve risks, including:
- an inability to perform a complete physical examination;
- insufficient image, audio, laboratory, or medical-record quality;
- delays or disruption caused by equipment, internet, or software failure;
- miscommunication or limitations in identifying nonverbal information;
- unauthorized access, security incidents, or privacy limitations despite safeguards;
- the need for in-person examination, urgent care, emergency care, or additional testing; and
- errors or delays when relevant medical information is incomplete or inaccurate.
5. Privacy and the medical record
#Telehealth communications and resulting reports may become part of your medical record. The applicable Partner Medical Practice uses safeguards designed to protect health information and will use and disclose it as described in its Notice of Privacy Practices.
You should participate from a private location, use a secure device and network when possible, and tell your provider if another person is present. Your provider may ask who is present and whether you consent to their participation.
6. Alternatives and right to withdraw
#You may choose in-person care from another provider as an alternative to telehealth. You may decline or withdraw consent to telehealth at any time without losing the right to future care, although withdrawal may make Everdawn’s virtual services unavailable or clinically inappropriate.
Your provider may stop a telehealth interaction and recommend in-person or emergency evaluation when necessary for safe care.
7. Testing and prescribing
#Telehealth does not guarantee a prescription, laboratory order, diagnosis, certification, or specific treatment. Providers must comply with federal and state prescribing rules and may require identity verification, additional records, testing, or an in-person examination.
8. Emergency plan
#You agree to provide accurate contact and location information so your provider can help direct emergency services if necessary. Telehealth messages are not continuously monitored and must not be used for urgent or emergency needs.
If the connection fails during a potentially urgent situation, call 911 or seek immediate local care rather than waiting for Everdawn to reconnect.
9. Consent acknowledgment
#By affirmatively accepting this consent during enrollment or before care, you acknowledge that you have read and understood the nature, potential benefits, risks, limitations, and alternatives of telehealth; had an opportunity to ask questions; consent to receive telehealth services; and understand how to withdraw consent.
Questions about this document?
Contact our privacy and compliance team and we will route your question to the appropriate Everdawn or medical-practice representative.
privacy@everdawn.health