Informed Consent to Telehealth

Telehealth is the delivery of health care services using interactive audio, video, or other electronic communications between a patient and a provider who are in different locations. At Aelia Health PLLC, telehealth may be used to provide evaluation, diagnosis, treatment, medication management (including MAT), follow-up, and patient education.

• Improved access to care, including from your home;
• Reduced travel time and time away from work, treatment, or family;
• More flexible scheduling, including evening and weekend options;
• Continuity of care and coordination with your other providers, such as your therapist or counselor.

While telehealth offers many benefits, there are potential risks and limitations, including:

• Technology may fail or be interrupted before or during a visit, requiring rescheduling or a switch to telephone;
• In rare cases, information transmitted may not be sufficient to allow for appropriate decision-making, and your provider may determine that an in-person evaluation or lab testing is needed;
• Certain physical examinations cannot be performed remotely;
• Despite reasonable safeguards, electronic transmission could, in rare cases, be disrupted or accessed by unauthorized persons.

To participate in a telehealth visit, you will need a device with a camera and microphone (such as a smartphone, tablet, or computer) and a reliable internet or cellular connection. You should be in a private, quiet, well-lit location. We will provide instructions for joining your visit. If a video connection cannot be established, your provider may offer to continue by telephone when clinically appropriate.

We use telehealth technology intended to comply with HIPAA and applicable Washington State law, including encryption designed to protect your information. Your telehealth visit will be treated with the same confidentiality as an in-person visit and documented in your medical record. We will not record your visit without your consent. You are responsible for protecting your own privacy at your location, including being in a private space. For more information, see our Notice of Privacy Practices.

Telehealth is not appropriate for medical emergencies. If you are experiencing an emergency, call 911 or go to the nearest emergency room. If you are in a mental health or substance use crisis, call or text 988.

At the start of each telehealth visit, we may confirm your physical location and a contact number so that, in the event of an emergency during the visit, we can direct emergency services to you. You agree to provide accurate location information for this purpose.

Telehealth is an alternative to, not a replacement for, in-person care. You have the right to receive in-person care, and your provider may recommend an in-person visit, referral, or lab testing when clinically appropriate. Choosing telehealth today does not prevent you from seeking in-person care in the future.

As with any medical care, no specific outcome or result can be guaranteed. Your provider will use professional judgment to determine whether telehealth is appropriate for your condition and may decline to provide services by telehealth if an in-person evaluation is warranted.

Telehealth services may be covered by Washington Apple Health (Medicaid) or your health plan. You are responsible for any applicable co-pays, deductibles, or fees not covered by your plan, consistent with your coverage and our billing policies.

Your participation in telehealth is voluntary. You have the right to withhold or withdraw your consent to telehealth at any time, without affecting your right to future care or treatment and without risking the loss or withdrawal of any benefits to which you are otherwise entitled. To withdraw consent, notify your provider or contact us using the information below.

By proceeding with telehealth services from Aelia Health PLLC, you acknowledge that you have read and understood this consent, that you have had the opportunity to ask questions, and that you consent to receive care through telehealth. A copy of this consent is available to you at any time and is documented as part of your care.

Questions about telehealth or this consent may be directed to Aelia Health PLLC at info@aeliahealthpllc.com or through our contact page.