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  • PPC

    Telehealth Consent Form

    Play Paediatric Consult
  • 1. I hereby authorize Play Paediatric Consult to use the telehealth practice platform for telecommunication for evaluating, testing and diagnosing my child's medical condition.

    2. I understand that technical difficulties may occur before or during the telehealth sessions and my appointment may not be started or ended as intended.

    3. I accept that the consultant paediatrician can conduct interactive sessions with video call; however, I am informed that the sessions may be conducted via regular voice communication if the technical requirements such as internet speed cannot be met.

    4. I understand that I am paying the stipulated fee for the Telehealth Service  out-of-pocket but may present a receipt to my insurance company for a refund where possible.

    5. I agree that my medical records on telehealth can be kept for further evaluation, analysis and documentation, and in all of these, my information will be kept private.

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