Yes. I consent to avail tele-therapy via telemedicine. I know the potential risks, consequences and benefits of tele-therapy.

Note:
a) I understand that leletherapy- includes consultation. treatment, health education and therapy. The modes utilized can be text (emails, messages), audio (telephone conversations) and video (conferencing).
b) The ethics and laws that protect the confidentiality of medical information also apply to information shared during teletherapy.
c) Presence of patient is highly advisable during the tele-therapy. This is as per the Telemedicine Practice Guidelines-2020 and Mental Healthcare Act. 2017
d) I accept that teletherapy does not provide emergency services. If symptoms worsen or become severe and/or side effects of the medication and/or emergency care is required, I will proceed to the nearest hospital emergency room for in-person consultation
e) The session reporting proforma will be kept in the patient’s file at the institute/hospital/clinic
f) Neither of the party (patient or psychiatrist) will not do audio or video recording, without pnor explicit consent.
g) The Telemedicine Practice Guidelines have stated (Code 4.1.1.2) that the patient will be responsible for the accuracy of the information shared with the doctor.
h) Homework assignment and compliance is an integral part of the teletherapy and will do my best to adhere to it.