Four Seasons Pediatrics

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Tele-Health video visits

Before connecting for Tele-Visits at Four Seasons Pediatrics, please review this consent. Please note, after reading the consent USE THE LINK emailed or texted to you to connect. Do not use this connection to connect to the doctor UNLESS you have been asked to do so.

I understand that my health care provider has agreed to have a Tele-Health visit with me.  Video conferencing technology will be used for the visit and will not be the same as a direct patient/health care provider visit. I understand that I will not be in the same room as my health care provider.  I understand there are potential risks to this technology, including interruptions, unauthorized access and technical difficulties.  I understand that my health care provider or I can discontinue the Tele-Health visit if either of us feel that the videoconferencing connections are not adequate for the situation.  Other staff may also be present during the visit other than my health care provider in order to make the connection work.   The above mentioned people will all maintain confidentiality of the information obtained.  The alternative to the Tele-Health visit is to have a direct office visit.   I understand that billing will occur from my healthcare providers office.  This link is used only after you are asked by the doctor to join for a call. Please click on the doctor’s name on the next page to connect for a Video Visit. By clicking “I Agree” you are giving your consent to use Tele-Health and that you have reviewed the above consent.

I AGREE

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