I hereby consent to participate in an advanced care management program under the direction of my healthcare provider. This program involves the use of technology to monitor my health data, such as vital signs and other relevant indicators, remotely. I understand that this data will be used by healthcare professionals to track my health status, detect potential health issues early, and customize my care management plan accordingly.
Authorization for Communication:
I authorize Vitrics Physician Group, PLLC and its designated staff to use phone calls, text messages, and emails to communicate with me regarding my care management, including but not limited to:
- Updates on my health status
- Reminders about medication and appointments
- Instructions related to my care plan
Privacy and Confidentiality:
I acknowledge that Vitrics Physician Group, PLLC will maintain the confidentiality and security of my health information in accordance with applicable laws and regulations. I understand that my data may be shared with other healthcare providers as necessary for my care management, under strict privacy protocols.
Acknowledgment and Agreement:
I have read and understand the information provided in this consent form. I have had the opportunity to ask questions and have them answered to my satisfaction. By signing below, I agree to participate in the Remote Physiologic Monitoring and Care Management Program (RPM / CCM / PCM / RTM / APCM) and authorize communication via phone calls, text messages, and emails as described above.