Consent to Treatment via Telehealth.
The purpose of this document is to provide comprehensive information about receiving treatment through telehealth services and to secure your informed consent for participation.
Consent for Treatment
By signing this document, you consent to and authorize Hedfirst, its affiliated medical practices, and licensed healthcare providers — including physicians, allied health professionals, mental health counselors, clinical social workers, nurses, and other qualified personnel — to provide evaluation, treatment, and related services.
You acknowledge the following:
- You have been informed of the recommended treatment's nature, goals, and potential outcomes, including counseling, assessments, and procedures.
- You understand that no guarantees or warranties have been made regarding treatment outcomes.
- You have the right to ask questions, seek clarification, and make informed decisions regarding your care.
- You may withdraw or withhold your consent without jeopardizing your right to future care.
Understanding Telehealth Services
Telehealth involves the use of secure electronic communication technologies to facilitate remote healthcare services. These technologies enable healthcare providers and patients in different locations to share medical information for diagnosis, treatment, medication management, follow-up, and education.
Your telehealth experience may include:
- Synchronous Video Communication: Real-time videoconferencing with your provider.
- Asynchronous Communication: Store-and-forward technologies for sharing medical data.
- Messaging: Secure communication portals for ongoing provider-patient interaction.
Telehealth is not intended for urgent or emergencies, nor is it a substitute for primary care.
Potential Benefits of Telehealth
- Convenient access to healthcare services from any location.
- Reduced travel time and associated costs.
- Improved access to specialists and continuity of care.
Potential Risks of Telehealth
While telehealth is designed to provide effective care, it may involve certain risks, including:
- Technical failures (e.g., connectivity issues, equipment malfunctions).
- Limited physical examination capabilities, which may impact diagnostic accuracy.
- Risks to privacy despite stringent security protocols.
Alternatives to Telehealth
Hedfirst offers in-person care options where available. Should telehealth be determined unsuitable for your condition, our team will assist in finding appropriate in-person care providers. You may choose alternative care methods at any time.
Privacy and Confidentiality
Hedfirst adheres to federal laws, including the Health Insurance Portability and Accountability Act of 1996 (HIPAA), to protect your personal health information.
- How Your Information is Used: Your data will be used for treatment, billing, administrative purposes, and as permitted by law.
- Data Security: Hedfirst employs state-of-the-art encryption and security protocols to safeguard your information.
For additional information, please refer to the Hedfirst Privacy Policy.
Emergencies and Crisis Situations
Telehealth is not suitable for urgent medical concerns or emergencies. In such cases, please:
- Call 911 or visit the nearest emergency room.
- For mental health crises or suicide prevention, contact the Suicide & Crisis Lifeline at 988 or 1-800-273-8255 for confidential, 24/7 support.
Provider Licensing Information
You can verify the licenses of Hedfirst providers through official state resources:
- New York State Providers: Visit the Office of the Professions Website to confirm your license status.
- Other States: Please consult your state’s medical board or equivalent licensing authority.
Financial Responsibility
By participating in telehealth services through Hedfirst, you acknowledge and accept responsibility for:
- Deductibles, co-payments, and co-insurance as dictated by your insurance plan.
- Full payment for services not covered by insurance or if insurance claims are denied.
Hedfirst will provide billing support, but the ultimate financial responsibility lies with you as the patient.
Acknowledgment of Rights
As a participant in Hedfirst’s telehealth program, you have the right to:
- Be informed of the nature, purpose, benefits, and risks of telehealth services.
- Access your medical records, subject to applicable policies and state laws.
- Exclude unauthorized individuals from being present during telehealth consultations.
- Withdraw your consent to telehealth services at any time without affecting your eligibility for future care.
Consent and Authorization
By proceeding with telehealth services through Hedfirst, you acknowledge that:
- You have read and understood the information provided regarding telehealth services.
- The potential benefits, risks, and alternatives to telehealth have been explained to your satisfaction.
- You have had the opportunity to ask questions and receive clear, complete answers.
- You voluntarily consent to receive healthcare services via telehealth through Hedfirst, understanding that you may withdraw your consent at any time without affecting your right to future care.