I accept the fact that in case this statement is untrue, neither this hospital nor the doctors are responsible for the caused consequences | I understand I may withhold or withdraw consent to teleconsultation at any time without affecting my right to future care or treatment |
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I agree to give my consent by ticking the below box knowingly, freely and voluntarily and agree to bind by its terms | In rare instances, security protocol could fail causing a breach of privacy of personal medical information d |
poor resolution of images to allow appropriate decision making by the consulted physician b.
20I understand there are possible risks of an incomplete or ineffective consultation because of the technology, and that if any of the risks occur, the consultation may terminate | I also acknowledge this consultation is limited to certain medical conditions for which the telehealth consultation services can be obtained and the proper procedures that shall be applied in emergency cases |
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I have been provided with enough information in a language that I can understand, to make an informed decision and I agree to have the Telehealth consultation Services | I understand the risks, consequences, benefits, and alternatives of the telemedicine consultation |
I understand the benefits of the telemedicine consultation such as Improve access medical care by enabling a patient to remain in their home, more efficient medical evaluation and access to expertise from distant specialist.
Dissemination of any patient identifiable images or information for this telehealth interaction to other entities will not take place without my consent | |
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I acknowledge I have read the guidelines on how the video conferencing technology will be used | The nature during the teleconsultation: a |
In rare cases, a lack of access to complete health records may result in adverse drug interaction, allergic reactions or other judgement errors I shall not hold the Medcare medical center authorities legally or financially responsible for any kind of loss or damage sustained by the procedure.