Telehealth Informed Consent
Effective Date: June 1, 2025
This document serves as your informed consent to receive healthcare services via telehealth from Diamond Palm Wellness (“we,” “us,” “our”). Please read the following carefully. By signing or otherwise acknowledging this consent, you agree to be legally bound by its terms.
1. Consent to Telehealth Services
By agreeing to this consent, you confirm that:
-
You have read and understood this document.
-
You consent to receive healthcare services via telehealth from Diamond Palm Wellness and its affiliated providers (“Providers”).
-
You will provide complete and accurate information to the best of your ability.
2. Purpose of This Consent
The purpose of this document is to inform you about the nature, benefits, risks, and limitations of receiving healthcare services through telehealth, and to obtain your agreement to proceed.
3. What Is Telehealth?
Telehealth involves the use of electronic communications to enable healthcare providers at different locations to evaluate, diagnose, treat, and advise patients remotely. These services may include:
-
Consultations
-
Health evaluations
-
Diagnosis
-
Treatment recommendations
-
Prescriptions (when clinically appropriate)
-
Referrals
All medical decisions, including whether a prescription is appropriate, are made solely at the discretion of the Provider.
4. Benefits of Telehealth
-
Greater access to care
-
More flexible scheduling
-
Convenience of receiving care from a preferred location
-
Faster communication and follow-up
5. Potential Risks of Telehealth
Telehealth has inherent limitations, which may include:
-
Incomplete or insufficient information for proper diagnosis or treatment
-
Delays in care due to technical issues
-
Limitations on treatment options due to state or federal regulations
-
Potential privacy or data breaches from electronic transmission
6. Service Limitations and Emergencies
-
No physical examination: Telehealth visits do not allow Providers to perform a physical exam, which may be necessary for certain conditions. Your Provider will determine whether telehealth is appropriate for your case.
-
No emergency care: Our Providers do not provide emergency or urgent care. If you are experiencing a medical emergency, call 911 or visit the nearest emergency room immediately.
-
Not a substitute for primary care: Our services do not replace your local primary care provider. We encourage you to maintain a relationship with a licensed primary care provider for ongoing health needs.
7. Confidentiality and Security
We are committed to protecting your personal health information in accordance with our Privacy Policy and applicable laws. However, electronic communication is not entirely risk-free. Possible risks include:
-
Unintended access or interception by third parties
-
Technical failures beyond our control
8. Patient Acknowledgments and Agreements
By accepting this Consent, you agree to the following:
-
You understand the risks and benefits of receiving healthcare via telehealth.
-
You give informed consent to receive telehealth services from Diamond Palm Wellness.
-
You will not seek emergency or urgent care through Diamond Palm Wellness.
-
You understand that you are not guaranteed treatment or a prescription. All care decisions are at the Provider’s professional discretion.
-
You accept that no guarantees are made regarding treatment outcomes.
-
You acknowledge that telehealth visits and related documentation become part of your medical record.
-
You release and hold harmless Diamond Palm Wellness, its Providers, employees, contractors, and affiliates from any liability related to loss of data, technical issues, or telehealth-related limitations.
9. Florida-Specific Notices
As a Florida-based provider, we direct you to your rights under applicable Florida law:
10. Release of Liability
By consenting to telehealth services, you agree to:
RELEASE AND HOLD HARMLESS Diamond Palm Wellness, its Providers, employees, contractors, agents, directors, members, officers, affiliates, and successors from and against any claims, damages, or losses related to or arising from telehealth services, including technical failures, delays in care, and breaches in data security beyond our control.
If you do not agree to the terms above, do not proceed with using Diamond Palm Wellness telehealth services.
For questions about this consent or our telehealth services, please contact us at:
Diamond Palm Wellness
Email: [info@diamondpalmwellness.com]
Website: www.diamondpalmwellness.com