| In rare instances, security protocol could fail causing a breach of privacy of personal medical information d | 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 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 agree to give my consent by ticking the below box knowingly, freely and voluntarily and agree to bind by its terms |
I understand the risks, consequences, benefits, and alternatives of the telemedicine consultation.
26| Information transmission may not be sufficient e | "Spinal Manipulation or Mobilization for Radiculopathy: A Systematic Review" |
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| "Spinal Manipulation or Mobilization for Radiculopathy: A Systematic Review" | 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 |
Leininger, Brent; Bronfort, Gert; Evans, Roni; Reiter, Todd 2011.
| Physical Medicine and Rehabilitation Clinics of North America | Delays in medical evaluation and treatment could occur due to deficiencies or failure of equipment c |
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| I understand I may withhold or withdraw consent to teleconsultation at any time without affecting my right to future care or treatment | I accept the fact that in case this statement is untrue, neither this hospital nor the doctors are responsible for the caused consequences |
Details of medical history, examination, x-rays and tests may be discussed with other healthcare professionals with interactive videos, audio and telecommunication technology.