Forma Medical WellnessDraft — not yet legal advice. This is a placeholder structure for Forma's licensed counsel to review and complete before launch.
Informed Consent to Telehealth
Last updated: [to be set on publish]
This consent explains how telehealth services work at Forma Medical Wellness so you can make an informed decision before your visit.
What telehealth is
Telehealth uses secure video, phone, and messaging to deliver care remotely. [Counsel to complete: describe the specific modalities Forma uses and the technology involved]
Potential benefits
Improved access to care, convenience, and timely evaluation. [Counsel to complete: list benefits specific to Forma's services]
Potential risks and limitations
A remote visit may limit a clinician's ability to examine you, technology may fail, and information transmitted electronically carries some risk. [Counsel to complete: detail risks, security measures, and limitations]
No guarantee of treatment or outcome
A consultation does not guarantee a prescription or any particular result; a clinician determines what is safe and appropriate. [Counsel to complete: confirm exact language]
Prescriptions
[Counsel to complete: describe prescribing policies, controlled-substance limitations, pharmacy fulfillment, and state-law constraints]
Emergencies
Telehealth is not for emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room.
Your rights
You may withhold or withdraw consent at any time and discuss alternatives with your clinician. [Counsel to complete: state patient rights and how to withdraw consent]
Consent
[Counsel to complete: final consent/acknowledgement statement the patient agrees to]