Consent Requirements

No reference found.

Prior to providing any telehealth medical service, the physician, to the extent possible, shall do all of the following…

• Obtain the patient’s consent for the use of telehealth as an acceptable mode of delivering health care services, including, but not limited to, consent for the mode of communication used and its limitations. Acknowledgment of consent shall be documented in the patient’s medical record.

SOURCE: AL Code Sec. 34-24-703, (Accessed Nov. 2023).

Before providing telehealth medical services, the physician must:

• Verify the patient’s identity;
• Require the patient to identify his or her physical location, including city and state;
• Disclose the identity and credentials of the physician and any other personnel; and
• Obtain the patient’s consent for the use of telehealth and document it in the patient’s medical record.

SOURCE: Alabama Board of Medical Examiners & Medical Licensure Commission, Telemedicine (Accessed Nov. 2023).

Board of Social Work

Upon initiation of telehealth services, a licensee shall:

• Obtain informed consent from the client. The consent shall be documented.

SOURCE: AL Admin Code 850-x-2-.04(2) (Accessed Nov. 2023).

Speech-Language Pathology

A licensee or registrant who provides telemedicine services under 12 ACC 07.020 shall document the efforts to obtain the client’s consent to send all records to the client’s primary care provider, if the licensee or registrant is not the client’s primary care provider.

If a client provides consent under (a) of this section, the licensee or registrant who provides telemedicine services shall obtain that consent in writing signed by the client or the client’s legal guardian.

SOURCE: AK Admin. Code, Title 12, Sec. 07.030 (Accessed Nov. 2023)

Nursing

The board may not impose disciplinary sanctions on an advanced practice registered nurse for rendering a diagnosis, providing treatment, or prescribing, dispensing, or administering a prescription drug that is not a controlled substance to a person without conducting a physical examination if

• the advanced practice registered nurse or another licensed health care provider in the medical practice is available to provide follow-up care; and
• the advanced practice registered nurse requests that the person consent to sending a copy of all records of the encounter to the person’s primary care provider if the prescribing advanced practice registered nurse is not the person’s primary care provider and, if the person consents, the advanced practice registered nurse sends the records to the person’s primary care provider

SOURCE: AK Statute Sec. 08.68.710, (Accessed Nov. 2023).

Nursing

For a telehealth encounter, an APRN must complete and document

• the patient’s informed consent to use telehealth technologies;
• a clinical history and review of systems establishing diagnoses and identifying conditions and contraindications to recommended treatment; and
• a plan of care that lists all recommendations and prescriptions issued by electronic means.

SOURCE: AK Admin Code Title 12, 44.925 (Accessed Nov. 2023).

Psychology

Licensees shall obtain informed consent of the recipient before providing distance professional services. To be effective, informed consent must be, understandable by the recipient, discuss the benefits and risks of entering into distance professional services, and address the use of telephone, online synchronous provision of psychological services, electronic billing, text, and email contact with a recipient.

SOURCE: AK Admin Code Title 12, 60.415, (Accessed Nov. 2023).

Before a health care provider delivers health care through telehealth, the treating health care provider shall obtain verbal or written informed consent, including by electronic means, from the patient or the patient’s health care decision maker. If the informed consent is obtained verbally, the health care provider shall document the consent on the patient’s medical record.

The consent requirement does not apply in the following circumstances:

• If the telehealth interaction does not take place in the physical presence of the patient.
• In an emergency situation in which the patient or the patient’s health care decision maker is unable to give informed consent.
• To the transmission of diagnostic images to a health care provider serving as a consultant or the reporting of diagnostic test results by that consultant.

SOURCE: Arizona Revised Statute Sec. 36-3602 (Accessed Nov. 2023).

Veterinarians

Notwithstanding any other law and except for an animal that is used in commercial food production that is regulated under title 3, a veterinarian may establish a veterinarian client patient relationship through electronic means if all of the following apply: …

• The veterinarian is licensed pursuant to this chapter or holds a permit pursuant to section 32-2217.01.
• The veterinarian obtains informed consent from the client, including an acknowledgement that the standards of care prescribed by this chapter apply to in-person visits and visits through electronic means. The veterinarian shall maintain for at least three years documentation of the consent described in this paragraph.
• The veterinarian provides the client with the veterinarian’s name and contact information and secures an alternate means of contacting the client if the electronic means is interrupted. The electronic or written record provided to the client after the telemedicine visit must include the veterinarian’s license number.
• Before conducting an evaluation of the patient through electronic means, the veterinarian advises the client of all of the following:
  • the veterinarian may ultimately recommend an in-person visit.
  • the veterinarian is prohibited by federal law from prescribing some drugs or medications based only on an electronic examination.
  • the appointment through electronic means may be terminated at any time.
• The veterinarian is able to recommend the client to a local veterinarian who can see the animal in person. The client has the option to choose an in-person visit.

SOURCE: Arizona Revised Statute 32-2240.03 (Accessed Nov. 2023).

The healthcare professional shall follow applicable state and federal laws, rules and regulations for informed consent.

SOURCE: AR Code 17-80-404. (Accessed Nov. 2023)

Speech-Language Pathology and Audiology

A licensee shall follow applicable state and federal law, rules, and regulations for: … informed consent.

SOURCE:  AR Board of Examiners in Speech-Language Pathology and Audiology Rules, Section 12: Telepractice, (Accessed Nov. 2023).

Before the delivery of health care via telehealth, the health care provider initiating the use of telehealth shall inform the patient about the use of telehealth and obtain verbal or written consent from the patient for the use of telehealth as an acceptable mode of delivering health care services and public health. The consent shall be documented.

SOURCE: CA Business & Professions Code Sec. 2290.5. (Accessed Jun. 2023). 

Occupational Therapy

An occupational therapist must obtain patient’s consent prior to providing services via telehealth.

SOURCE: CA Code of Regulations, Title 16, Div. 39, Art. 8, Sec. 4172(b). (Accessed Jun. 2023).

Behavioral Sciences

A licensee must obtain informed consent from a client upon initiation of telehealth services.

SOURCE: CA Code of Regulations, Title 16, Div. 18, Art. 1, Sec. 1815.5(c). (Accessed Jun. 2023).

Psychologists

A licensee must obtain and document informed consent for the provision of psychological health care services via telehealth from the client. Such consent shall cover concerns unique to the receipt of psychological health care services via telehealth, including risks to confidentiality and security, data storage policies and procedures specific to telehealth, the possibility of disruption and/or interruption of service due to technological failure, insurance coverage considerations, and other issues that the licensee can reasonably anticipate regarding the non-comparability between psychological health care services delivered in person and those delivered via telehealth.

SOURCE: CA Code of Regulations, Title 16, Div. 13.1, Art. 8, Sec. 1396.8(a). (Accessed Jun. 2023).

See Medicaid Consent section for additional requirements applicable to Medicaid.

Colorado Medical Board

Appropriate informed consent should be obtained for a telehealth encounter including those elements required by law and generally accepted standards of practice.

Informed consents obtained in connection with an encounter involving telehealth technologies should also be filed in the medical record.

SOURCE: The Colorado Medical Board Policies, 40-27, page 101-102. Guidelines for the Appropriate Use of Telehealth Technologies in the Practice of Medicine. 8/19/21. (Accessed Aug. 2023).

Colorado Mental Health Boards

Once a licensee, certificate holder, or registrant chooses to provide psychotherapy via electronic means, the licensee, certificate holder, or registrant is expected to carefully identify and address issues that involve implementing consent form(s) and proper disclosure(s) including, but not limited to the client’s knowledge regarding security issues, confidentiality, structure, etc.

SOURCE: State Board of Psychologist Examiners Policies, 30-1, p. 11. Teletherapy Policy – Guidance regarding Psychotherapy through Electronic Means. 2/2/18. (Accessed Aug. 2023).

Workers’ Compensation

SOURCE: 7 CO Regs. Rule 1101-3, 18-5(I), p. 30. (Accessed Aug. 2023).

Effective Now Until June 30, 2024

Notwithstanding the provisions of section 19a-906 of the general statutes, as amended by this act, if a telehealth provider provides a telehealth service to a patient during the period beginning on May 10, 2021 and ending on June 30, 2024, the telehealth provider shall, at the time of the telehealth provider’s first telehealth interaction with a patient, inform the patient concerning the treatment methods and limitations of treatment using a telehealth platform, including, but not limited to, the limited duration of the relevant provisions of this section and sections 3 to 7, inclusive, of public act 21-9, as amended by this act, and, after providing the patient with such information, obtain the patient’s consent to provide telehealth services. The telehealth provider shall document such notice and consent in the patient’s health record. If a patient later revokes such consent, the telehealth provider shall document the revocation in the patient’s health record.

During the period beginning on May 10, 2021 and ending on June 30, 2024, each telehealth provider shall, at the time of the initial telehealth interaction, ask the patient whether the patient consents to the telehealth provider’s disclosure of records concerning the telehealth interaction to the patient’s primary care provider. If the patient consents to such disclosure, the telehealth provider shall provide records of all telehealth interactions during such period to the patient’s primary care provider, in a timely manner, in accordance with the provisions of sections 20-7b to 20-7e, inclusive, of the general statutes.

During the period beginning on May 10, 2021 and ending on June 30, 2024, any consent or revocation of consent under this section shall be obtained from or communicated by the patient, or the patient’s legal guardian, conservator or other authorized representative, as applicable.

SOURCE: HB 5596 (2021 Session), sec. 1 & SB 2 (2022 Session), sec. 32. (Accessed Jul. 2023).

Permanent Statute

At the time of the telehealth provider’s first telehealth interaction with a patient, the telehealth provider shall inform the patient concerning the treatment methods and limitations of treatment using a telehealth platform and, after providing the patient with such information, obtain the patient’s consent to provide telehealth services. The telehealth provider shall document such notice and consent in the patient’s health record. If a patient later revokes such consent, the telehealth provider shall document the revocation in the patient’s health record.

Consent must be obtained by the parent or the patient’s legal guardian, conservator or other authorized representative, as applicable.

SOURCE: CT Gen. Statutes Sec. 19a-906(b)(2)&(e). (Accessed Jul. 2023).

Informed consent must be obtained to establish a physician-patient relationship over telehealth.

SOURCE: Title 24, Ch. 60, Sec. 6003(a)(3). (Accessed Jul. 2023).

Applies to Physical Therapists:

Before services are provided through telehealth, the licensee shall obtain written, informed consent from the patient, or other appropriate person with authority to make health care treatment decisions for the patient. For the purpose of this subsection, written consent includes an electronic signature. At minimum, the informed consent shall inform the patient and document acknowledgement of the risk and limitations of:

• The use of electronic communications in the provision of care;
• The potential breach of confidentiality, or inadvertent access, of protected health information using electronic communication in the provision of care; and
• The potential disruption of electronic communication in the use of telehealth.

SOURCE: 24 DE Administrative Code 2602. 14.2.2.1. (Accessed Jul. 2023).

Informed consent required by Boards (see regulation citations in Professional Board Standards tab).

Must obtain and document patient consent, except when providing interpretive services.

SOURCE: DC Regs. Sec. 17-4618.2, DC Department of Health Board of Medicine Policy No. 15-01. (Accessed June 2023).

No Reference Found

No Reference Found

No Reference Found

A patient’s informed consent for the use of virtual care shall be obtained as required by any applicable law.

In addition to the requirements of Section 54-5708, Idaho Code, evidence documenting appropriate patient informed consent for the use of telehealth technologies must be obtained and maintained at regular intervals consistent with the community standard of care. Appropriate informed consent should, at a minimum, include the following terms:

• Verification – Identification of the patient, the provider and the provider’s credentials.
• Telehealth Determination – Agreement of the patient that the provider will determine whether or not the condition being diagnosed and/or treated is appropriate for telehealth services.
• Security Measures Information – Information on the security measures taken with the use of telehealth technologies, such as encrypting data, password protected screen savers and data files, or utilizing other reliable authentication techniques, as well as potential risks to privacy and notwithstanding such measures.
• Potential Information Loss – Disclosure that the information may be lost due to technical failures.

SOURCE: ID Code Sec. 54-5708 & ID Admin Code 24.33.03 (205). (Accessed Jun. 2023).

Telepsychology

Telehealth providers will, upon initial contact with the service recipient except in an emergency, prior to providing telepsychology services, obtain the written, informed consent of the service recipient(s), consistent with accepted professional and legal requirements concerning:

• Limitations and challenges of using information technology to provide telepsycholoogy services;
• Potential for breaches in confidentiality of information while delivering telepsychology services;
• Risks of sudden and unpredictable disruption of telepsychology services and the alternative means by which communication may be re-established.

Telehealth providers will, upon initial and subsequent contact with the service recipient:

• Make reasonable efforts to verify the identity of the service recipient;
• Provide to the service recipient alternative means of contacting the telehealth provider should communications be disrupted during the provision of serbvices.
• Discuss who, in addition to the provider and the service recipient, may have access to the content of telecommunications between the provider and service recipient;
• Inform the service recipient of when and how the provider will respond to electronic messages;
• Ensure that a written agreement has been executed with service recipient(s) concerning compensation, billing, and payment arrangements.

SOURCE: ID Admin Code 24.12.01 (601(03)). (Accessed Jun. 2023).

READ LESS

No Reference Found

A health care provider (as defined in Indiana Code 16-18-2-163(a)) may not be required to obtain a separate additional written health care consent for the provision of telehealth services.

SOURCE: IN Code, 16-36-1-15. (Accessed Dec. 2023).

A practitioner who uses telehealth shall, if such action would otherwise be required in the provision of the same health care services in a manner other than telehealth, ensure that a proper provider-patient relationship is established. The provider-patient relationship by a practitioner who uses telehealth must at a minimum include the following:

(1) Obtain the patient’s name and contact information and:

• a verbal statement or other data from the patient identifying the patient’s location; and
• to the extent reasonably possible, the identity of the requesting patient.

(2) Disclose the practitioner’s name and disclose the practitioner’s licensure, certification, or registration.

(3) Obtain informed consent from the patient.

(4) Obtain the patient’s medical history and other information necessary to establish a diagnosis.

(5) Discuss with the patient the:

• diagnosis;
• evidence for the diagnosis; and
• risks and benefits of various treatment options, including when it is advisable to seek in-person care.

(6) Create and maintain a medical record for the patient. If a prescription is issued for the patient, and subject to the consent of the patient, the prescriber shall notify the patient’s primary care provider of any prescriptions the prescriber has issued for the patient if the primary care provider’s contact information is provided by the patient. The requirements in this subdivision do not apply when any of the following are met:

• The practitioner is using an electronic health record system that the patient’s primary care provider is authorized to access.
• The practitioner has established an ongoing provider-patient relationship with the patient by providing care to the patient at least two (2) consecutive times through the use of telehealth services. If the conditions of this clause are met, the practitioner shall maintain a medical record for the patient and shall notify the patient’s primary care provider of any issued prescriptions.

(7) Issue proper instructions for appropriate follow-up care.

(8) Provide a telehealth visit summary to the patient, including information that indicates any prescription that is being prescribed.

The medical records under subsection (b)(6) must be created and maintained by the practitioner under the same standards of appropriate practice for medical records for patients in an in-person setting.

A patient waives confidentiality of any medical information discussed with the practitioner that is:

1. provided during a telehealth visit; and
2. heard by another individual in the vicinity of the patient during a health care service or consultation.

SOURCE: IN Code, 25-1-9.5-7, b (Accessed Dec. 2023)

A written agreement must be employed documenting patient informed consent for the use of patient-physician e-mail. The agreement must be discussed with and signed by the patient and included in the medical record. The agreement must include the following terms:

1. Types of transmissions that will be permitted, such as: prescription refills;  appointment scheduling; and patient education.
2. Fees, if any, that will be assessed for on-line consultations or other electronic communication.
3. Under what circumstances alternate forms of communication or office visits must be utilized.
4. A statement that physician-patient e-mail is not to be used in emergency situations.
5. Instructions on what steps the patient should take in an emergency situation.
6. Security measures, such as encrypting data, password protected screen savers and data files, or utilizing other reliable authentication techniques, as well as potential risks to privacy.
7. Hold harmless clause for information lost due to technical failures.
8. Requirement for express patient consent to forward patient-identifiable information to a third party.
9. Patient’s failure to comply with the agreement may result in physician terminating the e-mail relationship.

SOURCE: IN Admin. Code, “Article 5” Title 844, 5-3-5. p. 11 (Accessed Dec. 2023). 

The parent or guardian of a student shall consent prior to the student receiving behavioral health services via telehealth under this chapter after a provider-patient relationship is established pursuant to this section. The school district shall maintain any such consent form completed by a parent or guardian.

SOURCE: IA Code Title VII Subtitle 6 Chapter 280A.3, (Accessed Aug. 2023).

Telepsychology

A licensee shall ensure informed consent for telepsychology includes a description of any limitations of services as a result of the technology utilized.

SOURCE: Iowa Admin Code, Sec. 645-243.7, (Accessed Aug. 2023).

Physician Assistants

Informed consent. A licensee who uses telemedicine shall ensure that the patient provides appropriate informed consent for the medical services provided, including consent for the use of telemedicine to diagnose and treat the patient, and that such informed consent is timely documented in the patient’s medical record.

See rule for more information about how Physician Assistants must disclose limitations about the drugs and services that can be provided via telemedicine, as well as financial interests and other important information during their meetings. A mechanism for the patient to give feedback must also be provided.

SOURCE: Iowa Admin Code, Sec. 645-327.9, (Accessed Aug. 2023).

Speech Pathology and Audiology

Prior to the first telehealth visit, a licensee shall obtain informed consent from the patient specific to the services that will be provided in a telehealth visit. At a minimum, the informed consent shall specifically inform the patient of the following:

• The risks and limitations of the use of technology to provide speech pathology or audiology services;
• The potential for unauthorized access to protected health information; and
• The potential for disruption of technology during a telehealth visit.

SOURCE: Iowa Admin Code, Sec. 645-301.1, (Accessed Aug. 2023).

Board of Dietetics

Prior to the first telehealth visit, a licensee shall obtain informed consent from the individual or group specific to the services that will be provided in a telehealth visit. At a minimum, the informed consent shall specifically inform the individual or group of the following:

• The risks and limitations of the use of technology to provide dietetics services;
• The potential for unauthorized access to protected health information; and
• The potential for disruption of technology during a telehealth visit.

SOURCE: Iowa Administrative Code Section 645.81.17, (Accessed Aug. 2023).

Hearing Aid Specialists

Prior to the first telehealth appointment with a client, the licensee shall obtain informed consent from the client that is specific to the service or services that will be provided in the telehealth appointment. The informed consent shall specifically inform the client of, at a minimum, the following:

• The risks and limitations of the use of technology to the specific service;
• The potential for unauthorized access to protected health information; and
• The potential for disruption of technology during a telehealth appointment.

SOURCE: Iowa Admin Code, Sec. 645-123.5, (Accessed Aug. 2023).

Nursing – ARNPs

Prior to providing services via telehealth, the licensee shall obtain consent from the patient, or the patient’s legal guardian or legal representative, to receive services via telehealth.

SOURCE: IA Admin Code Sec. 655-7.9(152), (Accessed Aug. 2023).

No Reference Found

The treating physician who delivers or facilitates the telehealth service shall obtain the informed consent of the patient before services are provided.

SOURCE: KY Revised Statutes § 311.5975. (Accessed Jul. 2023).

Patient consent must be obtained by:

• Physicians;
• Chiropractors;
• Nurses;
• Dentists;
• Dieticians or nutritionist;
• Pharmacist;
• Psychologists or psychological associate;
• Occupational therapists;
• Optometrist;
• Physical therapists;
• Speech language pathologists or audiologists;
• Social workers;
• Marriage/family therapists;
• Respiratory care practitioner

SOURCE: KY Revised Statutes 310.200, 311.5975, 312.220, 313.060, 314.155, 314A.230, 315.310, 319.140, 319A.300, 320.390, 327.200, 334A.200, 335.158, 335.380 & 314A.330, Originated from HB 177 (2000). (Accessed Jul. 2023).

Also see listing of Professional Board Regulation in Miscellaneous section for regulatory requirements for informed consent by profession.

The Board of Speech Language Pathology and Audiology requires their licensees to obtain informed consent of the client and inform the client in writing about:

• The limitations of using technology in the provision of telepractice;
• Potential risks to confidentiality of information due to technology in the provision of telepractice;
• Potential risks of disruption in the use of telepractice;
• When and how the licensee will respond to routine electronic messages;
• In what circumstances the licensee will use alternative communications for emergency purposes;
• Who else may have access to client communications with the licensee;
• How communications can be directed to a specific licensee;
• How the licensee stores electronic communications from the client; and
• That the licensee may elect to discontinue the provision of services through telehealth.

SOURCE: KY 201 KAR 17:110. (Accessed Jul. 2023).

See Medicaid Consent section for consent requirements established by the Cabinet for Health and Family Services.

Disclosures

Prior to utilizing telemedicine a physician shall insure that the following disclosures have been made to the patient and documented in the medical record. Such disclosures need not be made or documented more than once, except to update the information provided:

• The name, Louisiana medical license number and contact information [address, telephone number(s)] of the physician;
• The physician’s specialty or area of practice;
• How to receive follow-up and emergency care;
• How to obtain copies of medical records and/or insure transmission to another medical provider;
• How to receive care in the event of a technology or equipment failure; and
• Notification of privacy practices concerning individually identifiable health information, consistent with state and federal laws and regulations.

In addition to any informed consent and right to privacy and confidentiality that may be required by state or federal law or regulation, a physician shall insure that each patient to whom he or she provides medical services by telemedicine is:

• Informed of the relationship between the physician and patient and the respective role of any other health care provider with respect to management of the patient; and
• Notified that he or she may decline to receive medical services by telemedicine and may withdraw from such care at any time.

SOURCE: LA Admin. Code 46:XLV.7507 & 7511. p. 250-251 (Accessed Nov. 2023).

Board of Psychology

A thorough informed consent at the start of all services shall be performed.

The consent should be conducted in real-time.

Local, regional and national laws regarding verbal or written consent shall be followed.

The consent should include all information contained in the consent process for care including confidentiality and the limits to confidentiality in electronic communication:

• An agreed upon emergency plan, particularly in settings without clinical staff immediately available;
• The potential for technical failure, process by which patient information will be documented and stored;
• A protocol for contact between sessions; and
• Conditions under which telepsychology services may be terminated and/or a referral made.

SOURCE: LA Admin Code LAC Title 46:LXIII Sec. 1401-1409, (Accessed Nov. 2023).

Professional Counselors

At the onset of teletherapy, the licensee shall obtain verbal and/or written informed consent from the client and shall document such consent in the client’s record.

• Electronic signature(s) and date may be used in the documentation of informed consent.
• Provisions of informed consent for teletherapy services shall include:
  • mode and parameter of technology-assisted media(s), and technical failure;
  • scheduling and structure of teletherapy;
  • risks of teletherapy;
  • privacy and limits of confidentiality;
  • contact between sessions;
  • emergency plan;
  • consultation and coordination of care with other professionals;
  • referrals and termination of services;
  • information and record keeping;
  • billing and third-party payors;
  • ethical and legal rights, responsibilities, and limitations within and across state lines and/or international boundaries.

See regulation for additional requirements

SOURCE: LA Admin. Code LAC 46, Part LX, Subpart 1, Sec. 505 (Accessed Nov. 2023).

The department may not require a licensed facility to obtain written informed consent from a person receiving mental health services or substance use disorder treatment from the licensed facility during a public health emergency. A licensed facility shall obtain consent from a person receiving mental health services or substance use disorder treatment during a public health emergency; such consent may be obtained through verbal, electronic or written means.

The department shall adopt rules to implement this section. Rules adopted pursuant to this subsection are routine technical rules as defined in Title 5, chapter 375, subchapter 2-A.

SOURCE: ME Revised Statutes Annotated, Title 22, Ch. 1, Subchapter 2. §51. (Accessed Nov. 2023).

Board of Licensure in Medicine, State Board of Nursing, & Board of Osteopathic Licensure

A licensee who uses telehealth in providing health care shall ensure that the patient provides appropriate informed consent for the health care services provided, including consent for the use of telehealth to conduct a nursing assessment or physical examination, consultation, and diagnosis and treatment, and that such informed consent is timely documented in the patient’s telehealth record.

SOURCE: ME Regulation Sec. 02-373 Ch. 11, 02-380 Ch. 11, 02-383 Ch. 11. (Accessed Nov. 2023). 

Teledentistry 

Pursuant to 32 M.R.S. §18325(1) and Board Rules, Chapter 12, oral health services must be provided competently and professionally. Below are additional requirements that must be followed to ensure public safety when providing teledentistry services:

Provide informed consent to the patient for public display and in writing. Information on the informed consent must include the following:

• The licensee’s name, license number, credentials, qualifications, contact information, and practice location involved in the patient’s care;
• The name, license number, credentials, and qualifications of all dental personnel involved in the patient’s care; and
• A dentist who delegates a teledentistry service must ensure that the informed consent of the patient includes disclosure to the patient that the dentist has delegated the service.

SOURCE: ME Regulation Sec. 02-313 Ch. 15,  (Accessed Nov 2023).

Board of Social Worker Licensure

At the outset of providing services by telehealth, the social worker shall obtain informed consent from the client, or other appropriate person with authority to make health care decisions for the client. Social workers shall assess clients’ ability to provide informed consent.

At a minimum, the informed consent shall inform the client of:

• The benefits and risks of using telehealth in the provision of social work services. Examples of potential benefits include, but are not limited to, immediate access to services, convenient scheduling, privacy, and reduced or eliminated transportation barriers. Examples of potential risks include, but are not limited to, the lack of visual and auditory cues, delayed responses, the need for crisis services, confidentiality breaches, and technological failures.
• The potential risks to confidentiality of information due to the use of telehealth, such as the risks of entering private information when using a public access computer, or one that is on a shared network, and caution against using auto-fill usernames and passwords.
• The needs associated with the delivery of services via telehealth technology, for example having access to a computer or smartphone with the correct capabilities or internet access.
• The risk of the sudden and unpredictable failure of technology and alternative means of contacting the client if technology fails during a session with the client, and provide to the client alternative means of contacting the social worker.
• The local crisis telephone number and/or the local emergency mental health telephone number.
• Receiving services via telehealth may affect billing and access to insurance benefits.

The social worker will obtain written permission of the client prior to recording any part of the telehealth session and will disclose how the social worker will store and dispose of the recording file(s). If a recording is made a part of the clinical record, social workers shall retain and dispose of in accordance with Chapter 17 of board rules.

Clients should be given sufficient opportunity to ask questions and receive answers about telehealth services, and social workers shall revisit relevant informed consent issues as needed during the course of the client relationship.

Social workers shall maintain a record of the efforts to provide the information in this section.

SOURCE: ME Regulation, 02-416-18. (Accessed Nov. 2023).

In establishing a relationship between a practitioner and patient through interactive or asynchronous telehealth, health care practitioners must obtain oral or written consent from the patient or from the patient’s parent or guardian if State law requires the consent of a parent or guardian.

SOURCE: MD Health Occupations Code Sec. 1-1002(3). (Accessed Nov. 2023).

Psychologists

Before providing telepsychology services, a psychologist or psychology associate shall develop and follow a procedure that includes obtaining informed consent specific to telepsychology services using appropriate language understandable to the client.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.36.10.04. (Accessed Nov. 2023).

Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech Language Pathologists and Music Therapists

Except for interpretive services, obtain oral or written consent from a patient or patient’s parent or guardian if State law requires the consent of a parent or guardian, including informing patients of the risks and benefits of the services to be provided.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.41.06.04. (Accessed Nov. 2023).

Occupational Therapists, Physical Therapists, Chiropractors, and Dieticians

Before providing telehealth services, a telehealth practitioner shall develop and follow a procedure that includes obtaining oral or written consent from a patient or patient’s parent or guardian if State law requires the consent of a parent or guardian, including informing patients of the risks, benefits, and side effects of the recommended treatment plan.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.46.08.04 (Occupational Therapists); 10.38.13.04 (Physical Therapists); 10.43.17.04 (Chiropractors); 10.56.10.04 (Dieticians). (Accessed Nov. 2023).

Massage Therapists

Before performing telehealth services, a telehealth practitioner shall develop and follow a procedure that includes obtaining oral or written consent from a client or client’s parent or guardian if State law requires the consent of a parent or guardian, including informing clients of the risks, benefits, and side effects of the recommended health care services.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.65.10.04 (Massage Therapists). (Accessed Nov. 2023).

Professional Counselors and Therapists

Before providing teletherapy services, a teletherapy practitioner shall develop and follow a procedure that includes obtaining oral or written informed consent from a client or a client’s parent or guardian if State law requires the consent of a parent or guardian, including informing clients of potential risks and benefits of services to be performed.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.58.06.04 (Professional Counselors). (Accessed Nov. 2023).

Podiatrists

Before providing telehealth services, a telehealth practitioner shall develop and follow a procedure that includes, except for interpretive services, obtaining oral or written acknowledgement from a patient or a patient’s parent or guardian if State law requires the consent of a parent or guardian, including informing patients of the risks, benefits, and side effects of prescribed treatments.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.40.12.04 (Podiatrists). (Accessed Nov. 2023).

Social Workers

Before providing teletherapy services, a teletherapy practitioner shall develop and follow a procedure that includes obtaining oral or written informed consent from a client or a client’s parent or guardian if State law requires the consent of a parent or guardian, including informing clients of the risks, opportunities, and obligations associated with services available to the client.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.42.10.04 (Social Workers). (Accessed Nov. 2023).

Optometrists

Before performing telehealth services, a telehealth practitioner shall develop and follow a procedure that includes, except for interpretive services, obtaining oral or written consent from a patient or patient’s parent or guardian if State law requires the consent of a parent or guardian, including informing patients of the risks, benefits, and side effects of prescribed treatments.

SOURCE: Code of Maryland Admin. Regs. Sec. 10.28.01.04 (Optometrists). (Accessed Nov. 2023).

No Reference Found

A health professional shall not provide a telehealth service without directly or indirectly obtaining consent for treatment. This does not apply to a health professional who is providing a telehealth service to an inmate who is under the jurisdiction of the department of corrections and is housed in a correctional facility.

SOURCE: MI Compiled Laws Sec. 333.16284.  (Accessed Sept. 2023).

Optometry

An optometrist who provides telehealth services shall obtain informed consent for an established patient or informed consent for a new patient before providing  a telehealth service pursuant to section 16284 of the code, MCL 333.16284.  

An optometrist who provides a telehealth service shall maintain evidence of the  informed consent in the patient record and shall retain evidence of the informed consent in compliance with section 16213 of the code, MCL 333.16213.  

SOURCE: MI Administrative Code R 338.306 (Accessed Sept. 2023).

Athletic Trainers, Massage Therapy, Respiratory Care, Pediatric Medicine and Surgery, Veterinary Medicine

Consent for [medical advice] and treatment must be obtained before providing a telehealth service pursuant to section 16284 of the code, MCL 333.16284.

Evidence of consent for [medical advice] treatment must be maintained in a client/patient’s medical record.

SOURCE: MI Administrative Code R 338.1302, MI Administrative Code 338.702. MI Administrative Code R. 338.2201b, & MI Administrative Code R 338.8145, & MI Administrative Code R 338.4901a, (Accessed Sept. 2023).

Ostheopathic Medicine and Surgery, Genetic Counseling, Behavior Analyst, Board of Medicine, Psychology, Marriage and Family Therapy, Social Work, Audiology, Counseling

A licensee shall obtain consent for treatment before providing a telehealth service under section 16284 of the code, MCL 333.16284.

A licensee shall maintain proof of consent in the patient’s up-to-date medical record and satisfy section 16213 of the code, MCL 333.16213.

SOURCE: MI Administrative Code R. 338.2455, MI Administrative Code R 338.114, MI Administrative Code R. 338.1832, MI Administrative Code R. 338.2407, MI Administrative Code R. 338.2526, MI Administrative Code R. 338.7204, & R Administrative Code 338.2930, MI Administrative Code 338.13, & MI Administrative Code R 338.1758, (Accessed Sept. 2023).

Acupuncturist 

An acupuncturist shall obtain consent before providing a telehealth service pursuant to section 16284 of the code, MCL 333.16284.

SOURCE: MI Administrative Code 338.13003. (Accessed Sept. 2023).

Occupational Therapy

The licensee shall obtain informed consent for treatment before providing a telehealth service under section 16284 of the code, MCL 333.16284. Informed consent requires all of the following:

• The licensee shall ensure that the patient understands that treatment is provided remotely using telehealth.
• At the inception of care, any licensee who has contact with the patient shall identify himself or herself to the patient as an occupational therapist, occupational therapy assistant, or unlicensed individual.
• The licensee shall ensure that the patient is mentally capable of giving informed consent for diagnosis, care, or treatment.
• The licensee shall explain the alternatives, capabilities, and limitations of telemedicine and that the patient may decline to receive telehealth services.

If the patient is less than 18 years of age, or under the care of a legal guardian, a parent or legal guardian shall provide informed consent for the patient.

The licensee shall keep proof of consent for a telehealth service in the patient’s up-to-date medical record and satisfy section 16213 of the code, MCL 333.16213.

SOURCE: MI Administrative Code R 338.1243, (Accessed Sept. 2023).

No Reference Found

Practice of Medicine

The provider using any form of telemedicine, as defined in R.5.1, should obtain the patient’s informed consent before providing care via telemedicine technology. In addition to information relative to treatment, the patient should be informed of the risk and benefits of being treated via a telemedicine network including how to receive follow-up care or assistance in the event of an adverse reaction to treatment or if there is a telemedicine equipment failure.

SOURCE: MS Admin. Code Title 30, Part 2635, Rule 5.3. (Accessed Aug. 2023).

Optometry

The optometrist using telehealth to deliver optometric services or who practices tele-optometric treatment, upon initial contact with the patient shall: …

Obtain written, informed consent from the patient or other appropriate person with authority to make optometric/ health care treatment decisions for the patient before services are provided through telehealth.

SOURCE: MS Rules and Regulations, Title 30 Part 2901 Chapters 1-11.5, (Accessed Aug. 2023).

MS Department of Health: Occupational Therapy

The occupational therapist/occupational therapy assistant using telehealth to deliver occupational therapy services or who practices telehealth services, upon an initial contact with the patient shall:

• Verify the identity of the patient prior to each session;
• Obtain alternative means of contacting the patient;
• Arrange for the patient to have alternative means of contacting the occupational therapist or occupational therapy assistant;
• Provide contact methods of alternative communication the occupational therapist or occupational therapy assistant shall use for emergency purposes;
• Use personal identifying information only in secure communications;
• Obtain written, informed consent from the patient or other appropriate person with authority to make health care treatment decisions for the patient before services are provided through telehealth

SOURCE: Title 15, Part 19, Subpart 60, Rule 8.1.5 (Accessed Aug. 2023).

Collaborative Practice Arrangement with Nurses & Assistant Physician Collaborative Practice Agreements

Telehealth providers shall obtain patient’s or the patient’s guardian’s consent before telehealth services are initiated and shall document the patient’s or the patient’s guardian’s consent in the patient’s file or chart. All telehealth activities must comply with the requirements of the Health Insurance Portability and Accountability Act of 1996, as amended and all other applicable state and federal laws and regulations.

SOURCE: MO Code of State Regulation. Title 20, 2150-2.240 & Sec. 20, 2150-5.100. (Accessed Sept. 2023)

Nurses

Telehealth providers shall be required to obtain patient consent before telehealth services are initiated and ensure confidentiality of medical information.

SOURCE: MO Revised Statute Title XXII Occupations and Professions Ch. 335.175. (Accessed Sept. 2023).

Board of Psychologists

Licensees shall not commence a licensee-patient relationship via telehealth without an initial meeting for the licensee and patient who prospectively utilize telehealth. The licensee shall, at that initial meeting with the patient … inform the patient in writing about and obtain the patient’s informed written consent (see rule for requirements).

SOURCE: MT Admin Rules Sec. 24.189.415, (Accessed Nov. 2023).

Family Law – Parent and Child Rights

If the parental consent is given through telemedicine, the health professional shall verify the identity of the parent at the site where the consent is given.

SOURCE: MT Statute 46-6-701 as amended by HB 676, (Accessed Nov. 2023).

No Reference Found.  See Medicaid section for Medicaid-specific consent requirements.

Before providing services to a patient through teledentistry, a licensee shall: …

Obtain:

• Informed verbal or written consent that meets the requirements of subsection 4 from a patient who is an adult or a minor authorized by law to provide consent; or
• Informed written consent that meets the requirements of subsection 4 from the parent or guardian of a patient who is a minor and is not authorized by law to provide consent; and
• Document the informed consent provided pursuant to paragraph (d) in the record of the patient.

See statute for consent details.

SOURCE: NV Revised Statute Ch. 631 as added by AB 147 (2023 Session), (Accessed Jul. 2023).

Insurers shall not:

• Require an enrollee to establish an in-person relationship with a provider or provide any additional consent to or reason for obtaining services through telehealth.

SOURCE: NV Revised Statute Sec. 689A.0463; Sec. 689B.0369; Sec. 689C.195; Sec. 616C.730; Sec. 695A.265; Sec. 695B.1904; Sec. 695C.1708; Sec. 695D.216; & Sec. 695G.162. (Accessed Jul. 2023).

A physician providing services by means of telemedicine directly to a patient shall:

• Use the same standard of care as used in an in-person encounter;
• Maintain a medical record;
• Subject to the patient’s consent, forward the medical record to the patient’s primary care or treating provider, if appropriate; and
• Obtain oral or written consent from the patient or, if the patient is a minor, from the patient’s parent or guardian unless state or federal law allows a minor to consent to treatment without the consent of a parent or guardian, for the provision of services through telemedicine. For services delivered through telemedicine on an ongoing basis, the practitioner need obtain consent from the patient or parent or guardian only once.

SOURCE: NH Revised Statutes Annotated, 329:1-d-V(c) as amended by HB 500, (Accessed Jul. 2023).

At the time the patient requests health care services to be provided using telemedicine or telehealth, the patient shall be clearly advised that the telemedicine or telehealth encounter may be with a health care provider who is not a physician, and that the patient may specifically request that the telemedicine or telehealth encounter be scheduled with a physician. If the patient requests that the telemedicine or telehealth encounter be with a physician, the encounter shall be scheduled with a physician.  See statute for requirements if the health care provider is not a physician.

Following the provision of services using telemedicine or telehealth, the patient’s medical information shall be entered into the patient’s medical record, whether the medical record is a physical record, an electronic health record, or both, and, if so requested by the patient, forwarded directly to the patient’s primary care provider, health care provider of record, or any other health care providers as may be specified by the patient. For patients without a primary care provider or other health care provider of record, the health care provider engaging in telemedicine or telehealth may advise the patient to contact a primary care provider, and, upon request by the patient, shall assist the patient with locating a primary care provider or other in-person medical assistance that, to the extent possible, is located within reasonable proximity to the patient. The health care provider engaging in telemedicine or telehealth shall also refer the patient to appropriate follow up care where necessary, including making appropriate referrals for in-person care or emergency or complementary care, if needed. Consent may be oral, written, or digital in nature, provided that the chosen method of consent is deemed appropriate under the standard of care.

Consent for the waiver of in-person examination for the prescription of Schedule II controlled substances for a minor from the patient’s parent or guardian is also required.

SOURCE: NJ Statute C.45:1-62. (Accessed Aug. 2023). 

Prior to an initial contact with a patient for the purpose of providing services to the patient using telemedicine or telehealth, a licensee shall:

• Provide the client the opportunity to sign a consent form that authorizes the licensee to release records of the encounter to the patient’s primary care provider or other health care provider identified by the client.

SOURCE: NJ Administrative Code 13:30-9.4 (Dentist), 13:34-6A.4 (Marriage and Family Therapist), 13:34-32. (Marriage and Family Therapy Examiners),  13:34C-7.4 (Alcohol and Drug Counselor), 13:35-2C.4 (Physician Assistant), 13:35-12A4 (Electrologists), 13:35-6B.4 (Physicians), 13:35-8.24 (Hearing Aid Dispensers) 13:35-10.29 (Athletic Trainer) 13:37-8A4 (Nurses), 13:39A-10.4 (Physical Therapist & Physical Therapist Assistant), 13:44C-11.4.13:44-4A.4 (Veterinarians), 13:44C-11.4 (Audiology & Speech-Language Pathologist), 13:44F-11.4 (Respiratory Care), 13:44H-11.4 (Orthotics & Prosthetics), 13:44K-7.4 (Occupational Therapy), 13:44L-7.4 (Polysomnography) (Accessed Aug. 2023).

READ LESS

Hearing, Speech and Audiology Practitioners

A licensed audiologist, speech-language pathologist or hearing aid dispenser using telecommunication technology to deliver services to a client shall provide notice to the client, guardian, caregiver and multi-disciplinary team as appropriate, including but not limited to the right to refuse telehealth services, options for service delivery and instruction on filing and resolving complaints.

SOURCE: NM Administrative Code 16.26.2.20(G). (Accessed Nov. 2023).

Office of Alcoholism and Substance Abuse Services

Consent: a patient or potential patient’s acknowledgment that the benefits, limitations, and risks associated with services delivered via telehealth have been explained; and they have approved receipt of services via this modality either verbally or in writing. Providers are required to obtain informed consent prior to delivering services via telehealth. Informed consent may be in writing or verbal and noted in the patient record for each encounter.

SOURCE: OASAS Telehealth Standards for OASAS Designated Providers, p. 3, 8. Aug. 2023. (Accessed Nov. 2023).

Telepractice sessions shall not be recorded without the patient’s written consent.

SOURCE: NY Codes, Rules and Regulations, Title 14, Chapter XXI, Part 830.5. (Accessed Nov. 2023).

Applied Behavior Analysis, Mental Health Practitioners, Psychology Practice & Social Work

Licensed behavior analysts (LBAs) and certified behavior analyst assistants (CBAAs)/Mental Health Practitioners/Psychologists/Social Workers should develop procedures for and obtain informed consent prior to providing remote services and ensure that informed consent includes both benefits and risks.

SOURCE: NY Office of the Professions, Applied Behavioral Analysis, Practice Alerts – Telepractice; Mental Health Practitioner, Practice Alerts – Telepractice; Psychology Practice Alerts – Telepractice; Social Work Practice Alerts – Telepractice. (Accessed Nov. 2023).

Speech Language Pathology and Audiology

Should maintain appropriate documentation, including informed consent (risks and benefits) for use of telepractice which includes a client agreement to use a private environment with a secure connection, and documentation of the telepractice encounter.

SOURCE: NY Office of the Professions, Speech Language Pathology and Audiology Practice Guidelines. (Accessed Nov. 2023).

Physical Therapy:

“Consultation by telehealth” means that a physical therapist renders professional or expert opinion or advice to another physical therapist or professional health care provider via electronic communications or computer technology from a distant location. The patient’s written or verbal consent will be obtained and documented prior to such consultation. All records used or resulting from a consultation by means of telehealth are part of a patient’s record and are subject to applicable confidentiality requirements.

SOURCE: ND Admin. Code 61.5-01-02-01(3). (Accessed Nov. 2023).

A health care professional providing telehealth services shall obtain a patient’s consent before billing for the cost of providing the services, but the requirement to do so applies only once.

SOURCE:  Ohio Revised code 4743.09, (Accessed Nov. 2023).

Medical Board

“Consent for telehealth treatment” means a process of communication between a patient or, if applicable, the patient’s legal representative and the health care professional discussing the risks and benefits of, and alternatives to, treatment through a remote evaluation that results in the agreement to treatment that is documented in the medical record or signed authorization for the patient to be treated through an evaluation conducted through appropriate technology, as specified in this rule, when the health care professional is in a location remote from the patient.

The health care professional shall document the consent for telehealth treatment of the patient or, if applicable, the patient’s legal representative.

The health care professional shall promptly document in the patient’s medical record the patient’s or, if applicable, the patient’s legal representative, consent for telehealth treatment, pertinent history, evaluation, diagnosis, treatment plan, underlying conditions, any contraindications, and any referrals to appropriate health care providers, including primary care providers or health care facilities.

SOURCE: OH Administrative Code 4731-31-01 (Accessed Nov. 2023).

Speech Language Pathology

A provider is required to inform the patient of specific telehealth limitations. See rule for specific requirements.

SOURCE: OH Admin. Code 4753-2-01(D). (Accessed Nov. 2023).

Counseling, Social Work or Marriage and Family Therapy

During the initial session, licensees must establish informed consent in accordance with 4757-5-02(B) of the Administrative Code. Informed consent shall include information defining teletherapy delivery as practiced by the licensee, as well as potential risks, security issues, and confidentiality issue when receiving teletherapy. In the case of a minor client, the licensee must address any potential issues specifically associated with treating minors.

Informed consent should include a discussion of how teletherapy may affect billing and access to insurance benefits.

Licensees shall not provide services without client(s) informed consent which can be documented through verbal acknowledgement, online signature, or by signing a hard copy form. Licensees must make available to the client a copy of the consent documents regardless of the form of consent by the client.

SOURCE: OH Admin. Code 4757-5-13  (Accessed Nov. 2023).

Chiropractic Physicians

Provided that the standard of care for an in-person visit can be met for the patient and the patient’s medical condition through the use of the technology selected, each licensee that performs telehealth services must comply with the provisions outlined in Chapter 4734. of the Revised Code and Chapter 4734. of the Administrative Code. The following provisions additionally apply to telehealth services: …

• Consent to receive telehealth services must be documented in the medical record or signed authorization of the patient or, if applicable, the patient’s parent, guardian, or person designated under the patient’s health care power of attorney.

SOURCE: OH Admin Code 4734-8-10, (Accessed Nov. 2023).

Vision Professionals

“Consent for telehealth treatment” means a process of communication between a patient or, if applicable, the patient’s legal representative and the health care professional discussing the risks and benefits of, and alternatives to, treatment through a remote evaluation that results in the agreement to treatment that is documented in the medical record or signed authorization for the patient to be treated through an evaluation conducted through appropriate technology, as specified in this rule, when the health care professional is in a location remote from the patient.

A health care professional shall comply with all of the following administrative requirements to provide telehealth services to a patient which meet the standard of care including, but not limited to: …

• The health care professional shall document the consent for telehealth treatment of the patient or, if applicable, the patient’s legal representative

A health care professional shall comply with all of the following clinical requirements necessary to provide telehealth services to a patient which meet the standard of care including, but not limited to: …

• The health care professional shall promptly document in the patient’s medical record the patient’s or, if applicable, the patient’s legal representative, consent for telehealth treatment, pertinent history, evaluation, diagnosis, treatment plan, underlying conditions, any contraindications, and any referrals to appropriate health care providers, including primary care providers or health care facilities.

A health care professional may provide telehealth services through the use of remote monitoring devices for the purpose of data acquisition, patient communication, confirmation of expected therapeutic results, confirmation of stability/or homeostasis, and assessing changes in previously diagnosed chronic conditions, provided that:

• The patient or, if applicable, the patient’s legal representative, gives consent to the use of remote monitoring devices

SOURCE: Ohio Administrative Code 4725-25-01. (Accessed Nov. 2023).

If written consent is provided to a school district for assessment or treatment, such consent shall be effective for the school year for which it is granted and shall be renewed each subsequent school year. If an assessment or treatment is performed through telemedicine at a school site and if consent has been provided by the parent and is currently effective, the health professional shall not be required to verify that the parent is at the site. However, a child shall not be seen without consent.

SOURCE: OK Statutes Title 25, Chp. 21, Article 10 Sec.2005. (Accessed Dec. 2023).

Physical Therapy

Prior to the initiation of telehealth services, a Licensee shall obtain the patient’s consent to receive the services via telehealth. The consent may be verbal, written, or recorded and must be documented in the patient’s permanent record.

SOURCE: OR Administrative Rules, Sec. 848-040-0180(3). (Accessed Jul. 2023).

Occupational Therapy

Prior to initiation of occupational therapy services, an occupational therapy practitioner shall obtain informed consent of the delivery of service via telehealth from the patient/client.  The consent may be verbal, written or recorded and must be documented in the patient or client’s permanent health or education record.

SOURCE: OR Administrative Rules, Sec 339-010-006(4). (Accessed Jul. 2023).

Optometry

“Telehealth patient notice” means verbal and written notice given to the patient at the time of care that they are receiving telehealth services. Patients receiving refraction only services must receive that notification as well.

SOURCE: OAR 852-001-0002. (Accessed Jul. 2023).

No Reference Found

Será necesario que, previo a recibir los servicios de la telemedicina o telesalud, todo paciente suscriba una hoja de consentimiento informado expresando su conformidad a recibir los servicios. Si el paciente no está de acuerdo en la utilización de los servicios de la telemedicina o telesalud, el médico o profesional de la salud no deberá proveer los servicios, ni facturar ningún tipo de cargo por el paciente negarse a la consulta. El paciente mantiene la opción de aceptar o denegar el servicio en cualquier momento, sin que se afecte el derecho de recibir cualquier otro tipo de atención o cuidado.

SOURCE: 20 LPRA 6011i., 20 LPRA Section 6006.  (Accessed Jul. 2023).

An agreement should be employed documenting patient informed consent for the use of patient-physician e-mail and other text based communications. The agreement should be discussed with the patient to ensure his/her understanding of the guidelines. The agreement should include the following terms:

• Types of transmissions that will be permitted
• Circumstances when alternate forms of communication or office visits should be utilized
• Security measures, such as encryption of data, password protected screen savers and data files, or utilization of other reliable authentication techniques, as well as potential risks to privacy
• Hold harmless clause for information lost due to technical failures
• Requirement for express patient consent to forward patient-identifiable information to a third party
• A statement noting that the patient’s failure to comply with the agreement may result in termination of the e-mail relationship

SOURCE: RI Department of Health. Telemedicine. (Accessed Nov. 2023).

An agreement should be employed documenting patient informed consent for the use of patient-physician e-mail and other text based communications. The agreement should be discussed with the patient to ensure his/her understanding of the guidelines.  See guidelines for requirements.

SOURCE: Rhode Island Board of Medical Licensure and Discipline, Guidelines for the Appropriate Use of Telemedicine and the Internet in Medical Practice, (Accessed Nov. 2023).

No Reference Found

A health care professional using telehealth shall follow any applicable state or federal statute or rule for informed consent.

SOURCE: SD Codified Laws Sec. 34-52-7. (Accessed Aug. 2023).

For the purposes of this section, a healthcare provider-patient relationship with respect to telemedicine or telehealth is created by mutual consent and mutual communication, except in an emergency, between the patient and the provider. The consent by the patient may be expressed or implied consent; however, the provider-patient relationship is not created simply by the receipt of patient health information by a provider unless a prior provider-patient relationship exists. The duties and obligations created by the relationship do not arise until the healthcare provider:

• Affirmatively undertakes to diagnose or treat the patient; or
• Affirmatively participates in the diagnosis or treatment.

SOURCE:  TN Code Sec. 63-1-155 (Accessed Aug. 2023).

Dentists who are licensed in this state and who deliver services using teledentistry shall establish protocols for the practice that should include proper methods of keeping the patient fully informed.

SOURCE: TN Code Annotated 63-5-108, (Accessed Aug. 2023).

Worker’s Compensation

Telehealth services providers must obtain electronic or written informed consent of an injured worker to accept telehealth services for any or all parts of the medical benefits to which the injured worker may be entitled under the workers’ compensation law. For authorized telephone visits, verbal consent given by the patient before the service shall be documented by the provider. This service shall be in accordance with applicable CMS guidelines at the time of service. See rule for additional detailed requirements.

SOURCE:  TN Admin Code 0800-02-31.04, (Accessed Aug. 2023).

Optometry

An optometrist shall not render telehealth services, ophthalmic prescribing and eye health services, advice and/or care using telehealth technologies without:

Obtaining appropriate consents from requesting patients after disclosures regarding the delivery models and treatment methods or limitations, including any special informed consents regarding the use of telehealth technologies.

The consent by the patient may be expressed or implied consent; however, the optometrist-patient relationship is not created simply by the receipt of patient health information by an optometrist unless a prior optometrist-patient relationship exists.

SOURCE: TN Admin Code 1045-02-.18, (Accessed Aug. 2023).

A treating physician, dentist, or health professional who provides or facilitates the use of telemedicine medical services, teledentistry dental services, or telehealth services shall ensure that the informed consent of the patient, or another appropriate individual authorized to make health care treatment decisions for the patient, is obtained before telemedicine medical services, teledentistry dental services, or telehealth services are provided.

A dentist who delegates a teledentistry dental service shall ensure that the informed consent of the patient includes disclosure to the patient that the dentist has delegated the service.

SOURCE: TX Occupational Code Sec. 111.002, (Accessed Aug. 2023).

Informed Consent. In addition to the informed consent requirements in §108.7 of this title, and §108.8 of this title, informed consent must include the following:

• The delegating dentist’s name, Texas license number, credentials, qualifications, contact information, and practice location involved in the patient’s care. Additionally, the name, Texas license number, credentials, and qualifications of all dental hygienists and dental assistants involved in the patient’s care. This information must be publicly displayed and provided in writing to the patient; and
• A dentist who delegates a teledentistry dental service must ensure that the informed consent of the patient includes disclosure to the patient that the dentist delegated the service.

SOURCE: TX Administrative Code Title 22, Part 5, Ch. 108, Rule 108.16. (Accessed Aug. 2023).

Before providing chiropractic telehealth services, a licensee shall obtain a patient’s written informed consent.

SOURCE: TX Admin Code Title 22. Sec. 75.10. (Accessed Aug. 2023).

A provider offering telehealth services shall, prior to each patient encounter, and at least annual intervals, obtain informed consent to the use of telehealth services by clear disclosure of:

• additional fees for telehealth services, if any, and how payment is to be made for those additional fees if they are charged separately;
• to whom patient health information may be disclosed and for what purpose, including clear reference to any patient consent governing release of patient-identifiable information to a third-party;
• the rights of the patient with respect to patient health information;
• appropriate uses and limitations of the site, including emergency health situations;
• information affirming that the telehealth services meet industry security and privacy standards in Subsection 26-60-102(9)(b)(ii), and warning of potential risks to privacy regardless of the security measures;
• a warning that information may be lost due to technical failures, and clearly referencing any patient consent to hold the provider harmless for such loss; and
• information disclosing the website owner-operator, location, and contact information.

SOURCE: UT Admin Code R156-1-603. (Accessed Nov. 2023).

When a licensed dental professional uses teledentistry, the licensed professional shall ensure informed consent.  See regulations for requirements of consent.

SOURCE: UT Code, 58-69-807, (Accessed Nov. 2023).

A health care provider delivering health care services or dental services through telemedicine shall obtain and document a patient’s oral or written informed consent for the use of telemedicine technology prior to delivering services to the patient.

The informed consent for telemedicine services shall be provided in accordance with Vermont and national policies and guidelines on the appropriate use of telemedicine within the provider’s profession and shall include, in language that patients can easily understand:

• an explanation of the opportunities and limitations of delivering health care services or dental services through telemedicine;
• informing the patient of the presence of any other individual who will be participating in or observing the patient’s consultation with the provider at the distant site and obtaining the patient’s permission for the participation or observation; and
• assurance that all services the health care provider delivers to the patient through telemedicine will be delivered over a secure connection that complies with the requirements of the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191.

For services delivered through telemedicine on an ongoing basis, the health care provider shall be required to obtain consent only at the first episode of care.

The provider shall include the patient’s written consent in the patient’s medical record or document the patient’s oral consent in the patient’s medical record.

A health care provider delivering telemedicine services through a contract with a third-party vendor shall comply with the provisions of this subsection (c) to the extent permissible under the terms of the contract. If the contract requires the health care provider to use the vendor’s own informed consent provisions instead of those set forth in this subsection, the health care provider shall be deemed to be in compliance with the requirements of this subsection if he or she adheres to the terms of the vendor’s informed consent policies.

Notwithstanding any provision of this subsection to the contrary, a health care provider shall not be required to obtain a patient’s informed consent for the use of telemedicine in the following circumstances:

• in the case of a medical emergency;
• for the second certification of an emergency examination determining whether an individual is a person in need of treatment pursuant to section 7508 of this title; or
• for a psychiatrist’s examination to determine whether an individual is in need of inpatient hospitalization pursuant to 13 V.S.A. § 4815(g)(3).

Neither a health care provider nor a patient shall create or cause to be created a recording of a provider’s telemedicine consultation with a patient.

A patient receiving health care services or dental services by store-and-forward means shall be informed of the patient’s right to refuse to receive services in this manner and to request services in an alternative format, such as through real-time telemedicine services or an in-person visit.

Receipt of services by store-and-forward means shall not preclude a patient from receiving real-time telemedicine services or an in-person visit with the distant site health care provider at a future date.

Originating site health care providers involved in the store-and-forward process shall obtain informed consent from the patient as described in subsection (c) of this section.

SOURCE: VT Statutes Annotated, Title 18 Sec. 9361 (Accessed Dec. 2023).

Audio-Only Telephone

A health care provider delivering health care services by audio-only telephone shall obtain and document a patient’s oral or written informed consent for the use of audio-only telephone prior to the appointment or at the start of the appointment but prior to delivering any billable service.

The informed consent for audio-only telephone services shall be provided in accordance with Vermont and national policies and guidelines on the appropriate use of telephone services within the provider’s profession and shall include, in language that patients can easily understand:

• that the patient is entitled to choose to receive services by audio- only telephone, in person, or through telemedicine, to the extent clinically appropriate;

• that receiving services by audio-only telephone does not preclude the patient from receiving services in person or through telemedicine at a later date;

• an explanation of the opportunities and limitations of delivering and receiving health care services using audio-only telephone;

• informing the patient of the presence of any other individual who will be participating in or listening to the patient’s consultation with the provider and obtaining the patient’s permission for the participation or observation;

• whether the services will be billed to the patient’s health insurance plan if delivered by audio-only telephone and what this may mean for the patient’s financial responsibility for co-payments, coinsurance, and deductibles; and

• informing the patient that not all audio-only health care services are covered by all health plans.

For services delivered by audio-only telephone on an ongoing basis, the health care provider shall be required to obtain consent only at the first episode of care.

If the patient provides oral informed consent, the provider shall offer to provide the patient with a written copy of the informed consent.

Notwithstanding any provision of this subsection to the contrary, a health care provider shall not be required to obtain a patient’s informed consent for the use of audio-only telephone services in the case of a medical emergency.

A health care provider may use a single informed consent form to address all telehealth modalities, including telemedicine, store and forward, and audio-only telephone, as long as the form complies with the provisions of section 9361 of this chapter and this section.

SOURCE: 18 Vermont Statute Annotated Ch. 219, Sec. 9362. (Accessed Dec. 2023).

No reference found.

Evidence documenting appropriate patient informed consent for the use of telemedicine services must be obtained and maintained.  See guidance for list of what to include.

SOURCE: Telemedicine Guidance. Doc. # 85-12. VA Board of Medicine. P. 3 (Aug. 19, 2021). (Accessed Aug. 2023).

A practitioner who uses telemedicine should ensure that the patient provides appropriate informed consent, whether oral or written, for the medical services provided. A practitioner need not obtain informed consent in an emergency situation or in other situations recognized by Washington law.

SOURCE: Washington Medical Commission, Defining and Providing Guidance on Telemedicine Usage, p. 6 (November 19, 2021). (Accessed Jun. 2023)

For purposes of private payer contract requirements, “patient consent” means a voluntary and informed decision by a patient, following an explanation by the provider or auxiliary personnel under the general supervision of the provider presented in a manner understandable to the patient that is free of undue influence, fraud or duress, to consent to a provider billing the patient or the patient’s health plan for an audio-only telemedicine service under RCW 48.43.735 or WAC 284-170-433.

SOURCE: WA Rev. Code Sec. 284-170-130, (Accessed Jun. 2023).

If a provider intends to bill a patient or a managed health care system for an audio-only telemedicine service, the provider must obtain patient consent for the billing in advance of the service being delivered. The authority may submit information on any potential violations of this subsection to the appropriate disciplining authority.

If the commissioner has cause to believe that a provider has engaged in a pattern of unresolved violations obtaining consent (as required above) the commissioner may submit information to the appropriate disciplining authority for action. Prior to submitting information to the appropriate disciplining authority, the commissioner may provide the provider with an opportunity to cure the alleged violations.  See text for additional information.

SOURCE: Revised Code of Washington 71.24.335, 74.09.325, 48.43.735 & 41.05.700. (Accessed Jun. 2023).

A covered person’s consent must be obtained prior to initiation of the first audio-only encounter with a provider and may constitute consent to such encounters for a period of up to 12 months. If audio-only encounters continue beyond an initial 12-month period, consent must be obtained from the covered person for each prospective 12-month period.

Consent to be billed for audio-only telemedicine services must be obtained by the provider or auxiliary personnel under the general supervision of the provider. A covered person may consent to a provider billing them or their health plan in writing or verbally. Consent to billing for an audio-only telemedicine encounter may be obtained and documented by the provider or auxiliary personnel under the general supervision of the provider as part of the process of making an appointment for an audio-only telemedicine encounter, recorded verbally as part of the audio-only telemedicine encounter record or otherwise documented in the patient record. Consent must be documented and retained by the provider for a minimum of five years. As needed, a carrier also may request documentation of the covered person’s consent as a condition of claim payment.

A patient may revoke consent granted under this subsection. Revocation of the patient’s consent must be communicated by the patient or their authorized representative to the provider or auxiliary personnel under the general supervision of the provider verbally or in writing and must be documented and retained by the provider for a minimum of five years. Once consent is revoked, the revocation must operate prospectively.

SOURCE: WAC 284-170-433. (Accessed Jun. 2023).

Physicians and podiatrists must obtain from the patient appropriate consent for the use of telemedicine technologies.

SOURCE: WV Statute Sec. 30-14-12d & 30-3-13a. (Accessed Nov. 2023).

Athletic Trainers, Physical Therapists

An athletic trainer and physical therapist that provides telehealth services must obtain and maintain the informed consent of the patient, or of another individual authorized to make health care treatment decisions for the patient, prior to the provision of telehealth services.

SOURCE: WV Admin. Law Sec. 16-5-13.6,  WV Admin. Law Sec. 16-01-12.6, (Accessed Nov. 2023).

Occupational Therapy

Occupational therapy personnel shall obtain informed consent of the delivery of service via telehealth from the patient/client prior to initiation of occupational therapy services via telehealth and maintain documentation of the consent-to-treat process and content in the patient’s or client’s health records.

SOURCE: WV Admin. Law Sec. 13-09-5.1.c, (Accessed Nov. 2023).

Veterinarians

A veterinarian shall provide a client a clear mechanism to consent for the use of telehealth. As part of establishing the veterinarian-client relationship, the veterinarian assumes responsibility for medical judgements regarding the health of an animal and the client who is the owner or owner’s advocate of the animal consents to the veterinarian’s treatment plan.

SOURCE: WV Statute Sec. 30-10-24. (Accessed Nov. 2023).

Final Rule (Effective until August 1st, 2027) – Dentistry

In providing teledentistry services, a licensee or registrant shall, to the extent possible:

Obtain an appropriate informed consent from the requesting patient after disclosures have been made regarding the delivery models and treatment methods and limitations, to include any special informed consents regarding the use of teledentistry services.

See rule for more details about the requirements for informed consent in teledentistry.

SOURCE: WV Admin Law 5-16-4. (Accessed Nov. 2023).

Final Rule (Effective until August 1, 2030) – Social Workers

Prior to the provision of service, the social worker should obtain informed consent specific to telehealth services using appropriate language understandable to the client.  The practitioner-client relationship is established at the time informed consent is obtained.

SOURCE: WV Admin Law 25-1-5. (Accessed Nov. 2023).

Final Rule (Effective until August 1, 2033) – Nurses

A telehealth provider must obtain the patient’s consent to receive telehealth services.

SOURCE: WV Admin Law 19-16-7. (Accessed Nov. 2023).

Emergency Rule (Effective until August 1, 2029) – Professional Counselors & Marriage and Family Therapists

A telehealth provider must obtain the patient’s consent to receive telehealth services.

SOURCE: WV Admin Law 27-14-6. (Accessed Nov. 2023).

Final Rule (Effective until August 1st, 2027) – Osteopathic Medicine & Medicine

With the exception of the practice of pathology and radiology, a telehealth provider shall obtain the patient’s consent to receive telehealth services.

SOURCE: WV Admin Law 24-10-7 & WV Admin Law 11-15-7. (Accessed Nov. 2023).

Final Rule (Effective until August 1, 2028) – Optometrists

The provider of telehealth services shall provide to the patient or guardian a clear mechanism to provide consent for the use of telehealth. All consent and required notification shall occur prior to initiating any services. Patient medical records must meet the same requirements as in-person records including, but not limited to:

• record retention;
• informed consent;
• accessibility to both the licensee or registrant and the patient or legal guardian; and
• be consistent with all established laws and administrative regulations governing patient healthcare records, but not limited to, HIPAA.

SOURCE: WV Admin Law 14-12-3. (Accessed Nov. 2023).

When a physician uses a website to communicate to a patient located in this state, the physician may not provide treatment recommendations, including issuing a prescription, unless the following requirements are met:

• The physician shall be licensed to practice medicine and surgery by the medical examining board as required under s. Med 24.04.
• The physician’s name and contact information have been made available to the patient.
• Informed consent as required under s. 448.30, Stats., and ch. Med 18.
• A documented patient evaluation has been performed. A patient evaluation shall include a medical history and, to the extent required to meet or exceed the standard of minimally competent medical practice, an examination or evaluation, or both, and diagnostic tests.
• A patient health care record is prepared and maintained as required under ch. Med 21.

SOURCE: WI Admin. Code MED Ch. 24.07. (Accessed Aug. 2023).

Physical Therapy

Licensees shall ensure that patients have provided informed consent to the use of telehealth technology.

• Licensees shall disclose the risks of potential technology failures, including the potential loss of medical records or other information, and patients must provide their informed consent to these risks.
• If applicable, licensees shall disclose that they may photograph, record, videotape, and store records of the services electronically, and patients must provide their informed consent to these actions.
• Patients may provide their informed consent to these risks or actions through verbal or written agreement, including by email.

SOURCE: WY Admin Rules. Board of Physical Therapy. Ch. 7 Sec. 9. (Accessed Oct. 2023).

Occupational Therapy

The OT is responsible for determining whether any aspect of the provision of services may be conducted via telehealth or must be conducted in person.

The OT shall obtain informed consent for the delivery of service via telehealth from the client prior to initiation of occupational therapy services via telehealth and maintain documentation in the client’s health record.

SOURCE: WY Admin Rules. Board of Occupational Therapy. Ch. 3 Sec. 4. (Accessed Oct. 2023).

An individual who provides telehealth services to a patient in Wyoming shall: … Provide the patient, or the patient’s legal guardian, the opportunity to either sign or provide verbal consent to telehealth services

SOURCE: WY Admin Rules, Board of Athletic Trainers, Ch. 10, (Accessed Oct. 2023).

Chiropractic Examiners

A licensee should not render healthcare advice and/or care using telehealth technologies without: …

Obtaining appropriate consents from requesting patients after disclosures regarding the delivery models and treatment methods or limitations, including any special informed consents regarding the use of telehealth technologies. An appropriate licensee-patient relationship has not been established when the identity and credentials, including license status, of the provider may be unknown to the patient.

Informed Consent. Evidence documenting appropriate patient informed consent for the use of telehealth technologies must be obtained and maintained. Appropriate informed consent should, at a minimum, include the following terms:

• Identification of the patient, the provider and the provider’s credentials;
• Types of transmissions permitted using telehealth technologies (e.g. appointment scheduling, patient education, etc.);
• The patient agrees that the licensee determines whether or not the condition being diagnosed and/or treated is appropriate for a telehealth encounter; and
• Details on security measures taken with the use of telehealth technologies, such as encrypting data, password protected screen savers and data files, or utilizing other reliable authentication techniques, as well as potential risks to privacy notwithstanding such measures, and adherence to all applicable Health Insurance Portability and Accountability Act standards.

SOURCE: WY Admin Rules. Board of Chiropractic Examiners. Ch. 11 Sec. 2. (Accessed Oct. 2023).