Telemedicine Informed Consent

1. What Telemedicine Is

Telemedicine delivers health care while the patient and clinician are in different locations through electronic technologies. The service may include synchronous audio-video evaluation, electronic intake forms, secure submission of photographs or records, treatment planning, medication management, education, care coordination, and follow-up.

2. Mandatory Location Verification

You must accurately report where you are physically located during each encounter. At the start of every synchronous encounter, the treating clinician will verbally confirm and document your current physical location, including at least the city and state, before substantive clinical evaluation proceeds.

The clinician may use additional verification information, including security logs or approximate device or IP location when available through an approved system. Such information is supplementary and is not a substitute for direct confirmation.

If the clinician is not legally authorized to provide care where you are physically located, the encounter will not proceed except for appropriate emergency redirection.

3. Teledermatology-Specific Diagnostic Limitations

Teledermatology has unavoidable limitations compared with an in-person skin examination. The clinician cannot physically palpate your skin, perform dermoscopy or other office-based diagnostic techniques, obtain a biopsy, perform procedures, or examine areas that are not adequately visible through photographs or video.

Because of these limitations, serious conditions can be missed, misclassified, or diagnosed later than they would be with an adequate in-person examination. This includes melanoma, squamous cell carcinoma, basal cell carcinoma, serious infections, inflammatory disease, and other potentially significant or life-threatening conditions.

By proceeding with teledermatology, you acknowledge and voluntarily accept the risks inherent in remote visual assessment. This acknowledgment does not waive any legal right or reduce the professional standard of care that applies to the treating clinician.

4. Other Risks

• Incomplete or inaccurate assessment because of image quality, camera limitations, lighting, incomplete history, or inability to perform a hands-on examination.
• Need for in-person examination, biopsy, laboratory testing, imaging, procedure, urgent care, emergency care, or referral.
• Technology failure, interrupted transmission, delay, or inability to connect.
• Privacy and cybersecurity risks associated with electronic communication.
• Treatment delay while records, testing, or additional evaluation are obtained.

5. Alternatives

Alternatives include in-person care from a dermatologist, primary care clinician, urgent care center, emergency department, or other appropriate health professional. Dermatologic Services may not provide an in-person option through this direct-care service.

6. Prescriptions and Treatment

No prescription or specific treatment is guaranteed. Some medications require laboratory monitoring, pregnancy precautions, regulatory-program participation, follow-up, or additional examination. The clinician may decline to prescribe or may require additional information or care.

7. Photographs and Records

Clinical photographs and records may become part of your medical record. They will not be used for public marketing or social media without separate authorization when required by law.

8. Privacy and Technology

Dermatologic Services may use Google Workspace tools, including Google Meet, Google Forms, Google Calendar, and Google Drive, as well as Office Ally / Practice Mate and other approved vendors. Required Business Associate Agreements and safeguards are used when applicable.

Telemedicine sessions will not be recorded by Dermatologic Services unless you are specifically informed and any required consent is obtained. You agree not to record an encounter without the clinician's prior consent and compliance with applicable law.

9. Unencrypted Electronic Communications

Operational email or SMS may be offered for scheduling, intake links, receipts, and limited care-related communications. If you elect to receive unencrypted email or SMS, you will be asked to separately acknowledge the risk of interception or unauthorized access and request that communication method. You may withdraw that election prospectively and request another reasonable communication method.

10. Presence of Others

You should participate from a reasonably private location. Tell the clinician if another person is present. Clinical staff, interpreters, trainees, or others involved in care may participate when permitted by law. You may ask who is present and may object to non-essential observers.

11. Emergencies

Telemedicine through Dermatologic Services is not an emergency service. If you are experiencing an emergency, call 911 or your local emergency number or go to the nearest emergency department.

If an emergency becomes apparent during the encounter, the clinician may direct you to emergency care and may contact emergency services or an emergency contact when reasonably necessary and legally permitted.

12. Your Responsibilities

• Provide complete, truthful, and current medical information.
• Accurately state your physical location.
• Provide adequate photographs and records when requested.
• Disclose medications, allergies, pregnancy status when relevant, and significant medical conditions.
• Follow recommendations for testing, monitoring, follow-up, urgent care, emergency care, or in-person evaluation.
• Report significant adverse reactions or worsening symptoms.

13. Right to Decline or Withdraw

You may decline telemedicine or withdraw consent prospectively. If you withdraw, Dermatologic Services may be unable to provide remote care and may recommend another care setting.

14. Medical Records

Information obtained during telemedicine is documented in the medical record as required or appropriate. Office Ally / Practice Mate is used as the formal chart for the direct-care workflow.

15. Acknowledgment

• You understand teledermatology's benefits, risks, limitations, and alternatives.
• You understand that remote visual inspection can miss serious disease, including skin cancer.
• You understand that prescriptions and specific treatments are not guaranteed.
• You consent voluntarily to telemedicine care.