- DocViaWeb is the consulting health care provider will be at a different location from me. A provider or other healthcare provider may be present in the room to assist in the consultation.
- DocViaWeb is the presenting practitioner may transmit or share details of my medical history, examination, x-rays, tests photographs or other images electronically with a provider who is at a different location.
- DocViaWeb I will be informed if any additional personnel are to be present other than myself, individuals accompanying me, the presenting practitioner and via video, the consultant. I will give my verbal permission prior to the entry of additional personnel.
- DocViaWeb is the provider or healthcare provider for whom on-site examination or treatment is performed (the "presenting practitioner") will keep a record of the consultation in my medical record.
- DocViaWeb release of information Practitioners who provide professional services are authorized to furnish medical information to the referring provider, to any insurance company or third party payer for purpose of obtaining payment of the account. I authorize the release of information from my medical record to any other healthcare facility or provider to which my care may be transferred.
- DocViaWeb I voluntarily consent to healthcare services provided by my doctor(s) or designee's, which may include diagnostic tests, drugs, examinations, and medical or surgical treatments considered necessary to treat my health problems.
- DocViaWeb I understand I may be released before all my medical problems are known or treated, and it is my responsibility to make arrangements for follow-up care or seek additional healthcare in the event of an emergency.
- DocViaWeb I understand I have the option to refuse telehealth services at any time without affecting the right to future care or treatment.
- DocViaWeb I understand a variety or alternative methods of medical care may be available to me, and I may choose one or more of these at any time.
- DocViaWeb I understand I have the right to withhold or withdraw my consent to the use of telemedicine in the course of my care at any time, without affecting my right to future care or treatment.
- DocViaWeb I understand the laws that protect privacy and the confidentiality of medical information also apply to telemedicine, and that no information obtained in the use of telemedicine which identifies me will be disclosed to researchers or other entities without my consent.
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