JTP st consent
Just The Pill - Consent to Telehealth Services
Telehealth is the delivery of health care services using interactive audio and visual electronic systems between a provider and a patient that are not in the same physical location. These services may also include electronic prescribing, appointment scheduling, communication via email or electronic chat, electronic scheduling, and distribution of patient education materials.
I hereby consent to engaging in telehealth services with Just The Pill as part of my healthcare evaluation and treatment. I understand that "telehealth" includes the practice of health care delivery, diagnosis, consultation, treatment, transfer of medical data, and education using interactive audio, video, or data communications. I have read this document and understand the risk and benefits of the telehealth services. This consent may be revoked verbally or in writing at any time.
If patient is under 18 or has a legal guardian:
Signature of Patient (or Parent/Guardian):
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: JTP st consent
Agree & Sign