PATIENT CONSENT
PURPOSE: The purpose of "Teleconsulation appointment form" is to get the patient's consent in order to conduct teleconsultation. The patient understands and agrees that:
1. The Patient hereby authorise Sportsperformance Physiotherapy to use the telehealth practice platform for telecommunication for evaluating, testing and diagnosing his/her medical condition.
2. Technical difficulties may occur before or during the telehealth sessions and his/her appointment cannot be started or ended as intended.
3. The professionals can conduct interactive sessions with video call; however, The Patient is informed that the sessions can be conducted via regular voice communication if the technical requirements such as internet speed cannot be met.
4. The Patient's current insurance may not cover the additional fees of the telehealth practices and may be responsible for any fee that that insurance company does not cover.
5. The Patient's medical records on telehealth can be kept for further evaluation, analysis and documentation, and in all of these, his/her information will be kept private.
6. Under certain situation, his/her condition cannot be diagnosed by the mean of teleconsultation and he/she might need to further arrange another face-to-face consultation to properly assess the condition. This current teleconsultation will still be considered as a completed consultation.
7. If a further face-to-face consultation is needed, the patient understands it is solely up to his/her own decision.
8. If the patient is under 18 years old, an accompany adult (parents, guardians or next of kin) must be present with the patient during the consultation.