This Telehealth Consent form outlines the benefits, risks, and your rights regarding telehealth services provided by Gut and Gastro.
1. Telehealth Services Definition
Telehealth involves the use of electronic communications to enable healthcare providers at Gut and Gastro to deliver clinical services to patients remotely. The electronic systems used will incorporate network and software security protocols to protect the confidentiality of patient information.
2. Benefits of Telehealth
- Improved access to gastroenterological care and expertise
- Convenience of receiving care from the comfort of your home
- Reduced need for travel
- Enhanced continuity of care and follow-up
- Ability to monitor and manage chronic digestive conditions remotely
3. Potential Risks
- Information transmitted may not be sufficient for proper medical decision-making
- Technical failures may delay medical evaluation or treatment
- Security protocols could fail, resulting in a breach of privacy of personal medical information
- Lack of physical examination may result in some conditions not being identified
4. Your Rights
You have the right to:
- Withhold or withdraw consent at any time
- Ask questions about the telehealth process
- Request an in-person consultation instead of a telehealth visit
- Be informed of all individuals who will be present during telehealth consultations
- Exclude anyone from participating in or observing your consultation
5. Medical Emergency Procedures
Telehealth is not intended for emergency situations. In case of an emergency, call 911 or proceed to the nearest emergency room. For urgent issues that are not life-threatening, please contact our on-call provider through our messaging system.
6. Open Payments Disclosure
In compliance with the Physician Payments Sunshine Act (Open Payments), Gut and Gastro discloses any payments or transfers of value received from pharmaceutical and medical device companies. Our healthcare providers prioritize your care based on medical evidence and clinical judgment, not industry relationships.
7. By Using Our Telehealth Services
By proceeding with using our telehealth services, you acknowledge that you:
- Understand the risks and benefits of telehealth
- Consent to receive services via telehealth technologies
- Agree that your electronic signature (provided during registration) is legally binding
- Have had the opportunity to ask questions about telehealth
8. Contact Information
If you have any questions about this Telehealth Consent, please contact us at info@gutandgastro.com.
