Telehealth Informed Consent

Effective Date:February 1, 2026

Telehealth services involve the use of electronic communications to provide healthcare services when the patient and provider are not in the same physical location. By using Empire Medical Care’s telehealth services, you acknowledge and provide informed consent as described below.

What Is Telehealth

Telehealth allows licensed healthcare providers to evaluate, diagnose, and treat patients using secure audio, video, and electronic communication technologies. These services may include medical consultations, treatment recommendations, follow-up care, and medication guidance when clinically appropriate.

Expected Benefits

  • Improved access to medical care without traveling to a clinic

  • Timely evaluation for common, non-emergency health concerns

  • Convenience and continuity of care

Potential Risks & Limitations

You understand and acknowledge that:

  • Telehealth may not be appropriate for all medical conditions

  • Delays in care may occur due to technical issues

  • Lack of physical examination may affect diagnostic accuracy

  • In rare cases, security breaches could occur despite safeguards

  • Providers may determine in-person care is required

Emergency Care Disclaimer

Telehealth services are not intended for medical emergencies.
If you experience chest pain, severe shortness of breath, loss of consciousness, severe bleeding, or other emergency symptoms, call 911 immediately or go to the nearest emergency room.

No Guarantee of Outcomes

You understand that:

  • No diagnosis, treatment, or prescription is guaranteed

  • Prescriptions are issued only when clinically appropriate

  • Certain medications may not be prescribed via telehealth

Patient Responsibilities

You agree to:

  • Provide accurate, complete, and current medical information

  • Disclose medications, allergies, and medical history

  • Follow provider instructions and seek in-person care when advised

Privacy & Confidentiality

Telehealth services are subject to the same privacy protections as in-person care. Your Protected Health Information (PHI) is handled in accordance with HIPAA and applicable state laws.

Consent Acknowledgment

By proceeding with Empire Medical Care’s telehealth services, you confirm that:

  • You have read and understood this document

  • You understand the benefits and risks of telehealth

  • You voluntarily consent to receive telehealth services

📧 Questions: info@empiremedicalcare.com

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