Telehealth Informed Consent

This is a template informed-consent document. Several states (including FL, GA, CO, VA, TX, MN, MI, CA) have specific telehealth consent requirements. Before launch, have this reviewed by a healthcare attorney familiar with each state where you practice.

1. What is telehealth?

Telehealth is the delivery of healthcare services using live video, secure messaging, and other electronic means, in lieu of an in-person visit. At ADHD Telemed, telehealth is used for evaluations, follow-up visits, and medication management with our licensed clinicians.

2. Benefits of telehealth

• Convenient access from home, eliminating travel and time-off-work barriers
• Comparable diagnostic accuracy to in-person visits for ADHD assessment
• Greater scheduling flexibility
• Reduced exposure to crowded waiting rooms
• Continuity of care — your same physician at each visit

3. Limitations and risks

• Technology failures: Video, audio, or connectivity issues may interrupt or shorten a visit. Backup plans (phone call, rescheduling) are in place.
• Limited physical exam: Certain physical exam findings may not be observable via video. If your clinician determines that an in-person visit is needed, they will refer you accordingly.
• Privacy considerations: Although we use HIPAA-compliant video, the privacy of your environment during the visit is your responsibility. Choose a quiet, private space.
• Security: Although we use industry-standard encryption, no electronic system is 100% secure. There is a small risk of unauthorized access.

4. Recording

ADHD Telemed does not record telehealth visits without your written consent. You may not record any portion of your visit (audio or video) without the express written consent of your clinician.

5. Emergency situations

Telehealth is not appropriate for medical or psychiatric emergencies. If you are experiencing a life-threatening situation, call 911. If you are in mental-health crisis, call or text the 988 Suicide & Crisis Lifeline.

6. Prescribing

Whether to prescribe medication — and what to prescribe — is solely a clinical decision made by your physician based on a thorough evaluation. Prescription of controlled substances (e.g., stimulant ADHD medications) is governed by federal DEA rules and applicable state law, including any in-person visit requirements.

7. State licensure

Your clinician must be licensed in the state where you are physically located at the time of your visit. ADHD Telemed is currently licensed to provide telehealth in: Florida, Georgia, Colorado, Virginia, Texas, Minnesota, Michigan, and California. If you relocate or travel out of a licensed state, please notify us — we may need to reschedule.

8. Your rights as a telehealth patient

• You have the right to refuse telehealth and request an in-person referral, where available.
• You have the right to discontinue telehealth at any time.
• You have the right to access your medical record.
• You have the right to know who is participating in your visit.
• You have the right to expect that all information shared during a telehealth visit is held in the same confidence as an in-person visit.

9. Consent

By scheduling and attending a telehealth visit with ADHD Telemed, you acknowledge that you have read and understand this Informed Consent, including the benefits, limitations, and risks of telehealth; and you voluntarily consent to receive healthcare services from ADHD Telemed by telehealth.

If you have any questions about telehealth or about your specific situation, contact us at hello@adhdtelemed.com before scheduling.