Telehealth Informed Consent

Please read this informed consent before your first visit. By scheduling and attending a telehealth visit with ADHD Telemed, LLC, you (or your parent or guardian, for patients age 13 to 17) consent to receive care by telehealth as described below.

1. What telehealth is

Telehealth is the delivery of healthcare using live video, audio, secure messaging, electronic intake forms, and review of documents, instead of an in-person visit. ADHD Telemed uses telehealth for evaluations, follow-up visits, and medication management with licensed physicians.

2. Purpose of the evaluation

Your physician will determine whether your symptoms and history support a diagnosis, whether ADHD or another condition is likely, whether treatment is appropriate, and whether telehealth is a safe setting for your care. Screening questionnaires such as the ASRS, GAD-7, and PHQ-9 help organize information but do not by themselves diagnose or rule out any condition.

3. Benefits

• Access to care without travel or time away from work or school
• Greater scheduling flexibility
• Continuity with the same physician for follow-up

4. Risks and limitations

• Your physician cannot perform a full physical exam or directly measure vital signs by video, and may ask you for blood pressure, heart rate, weight, labs, records, or an in-person exam.
• Technology problems may interrupt or shorten a visit; we will reconnect by phone or reschedule.
• Although we use HIPAA-compliant, encrypted systems, no electronic system is completely secure.
• Your physician may decide telehealth is not appropriate and refer you for in-person care.

5. Identity and location

You will be asked to verify your identity and your physical location at each visit. Your physician must be licensed in the state where you are located at the time of the visit (currently Florida, Georgia, Colorado, Virginia, Texas, Minnesota, Michigan, Ohio, and California). If you are traveling or cannot confirm your location, the visit may be rescheduled. Please do not attend a visit while driving.

6. Medication and controlled substances

Medication may or may not be prescribed; it is never guaranteed. Controlled medications, including stimulants, are prescribed only when clinically appropriate and in compliance with federal DEA rules and state law, including any in-person requirements. Your physician may review your state prescription monitoring program (PDMP) record and may require a controlled-substance agreement, periodic follow-up, and monitoring. Take medication only as directed, never share or sell it, and report side effects such as chest pain, palpitations, fainting, severe anxiety, agitation, or mood changes promptly.

7. Emergencies

Telehealth is not for emergencies. If you have a life-threatening problem, call 911 or go to the nearest emergency room. If you are in a mental-health crisis, call or text 988. Do not use messages, email, or website forms for emergencies.

8. Privacy and recording

Attend visits from a private, safe location. We do not record visits without your written consent, and you may not record a visit without your physician's written consent. Your information is handled as described in our Privacy Policy and Notice of Privacy Practices.

9. Minors

Patients age 13 to 17 require the participation and consent of a parent or legal guardian unless state law provides otherwise. Your physician may also speak with a teen privately when clinically appropriate and permitted by law.

10. Your rights

• You may decline telehealth and seek in-person care at any time.
• You may stop a telehealth visit at any time.
• You have the right to know who is present during your visit.
• You have the right to access your medical records.

11. Alternatives

Alternatives include in-person care with a primary care clinician, psychiatrist, or psychologist; neuropsychological or school-based testing; therapy; or no treatment.

Questions before scheduling? Contact hello@adhdtelemed.com or (305) 209-8356.