1.    This practice uses Telehealth to communicate and correspond with patients. By signing this form, you consent to receive Telehealth services.

a. this is including but not limited to things like emails, texts, phone calls, and electronic health records. AI may be used in the day to day activities in your care.

b. other forms of technology may be used in order to provide you with care as deemed appropriate and in accordance with appropriate rules and regulations (including HIPAA).

2.    Your privacy will be maintained using HIPAA compliant platforms for all communications (email, text, phone, video).

a.In order to participate in Telehealth sessions, you as the patient/client will also be requested to maintain a space of privacy, free from distraction in order to maximize the time we have together and maintain HIPAA.

3.    If you are in need of additional accommodations, we will discuss these needs and determine the appropriate course of action together.

a. example, if an interpreter is required, one will be secured prior to scheduled appointments.

4.    If you are not able to participate in Telehealth visits, in person visits will be offered. If other forms of telecommunication are not appropriate for you, you will be provided alternative options.