Telehealth Informed Consent

"Telehealth" means the use of secure, HIPAA-compliant video and audio technology to deliver clinical services when the patient and provider are in different locations. Services may include evaluation, diagnosis, treatment planning, medication management, and follow-up care.

• Access to specialty care without travel.
• Timely follow-up and treatment planning.
• Continuity of care between in-office visits.

• The provider cannot perform a hands-on physical exam. Some conditions may not be fully diagnosable or treatable by telehealth and may require an in-person visit or a procedure.
• Technical failures, poor connectivity, dropped audio or video, may interrupt the visit. If a session fails, we will attempt to reconnect or reschedule.
• Although we use encrypted platforms, no electronic communication is completely secure. Protocol breaches are possible.
• Electronic transmission of your PHI to other providers may occur for continuity of care.

• You may withhold or withdraw consent at any time without affecting your right to future care.
• You may request an in-person visit instead of telehealth.
• You have access to all information transmitted during a telehealth visit as part of your medical record.
• No images or recordings will be made without your written consent.

Jonas Santos, DO is licensed to practice medicine in Florida. You must be physically located in a state where the provider is licensed at the time of the visit. You are responsible for informing us of your location at the start of each visit.

Certain medications, including controlled substances, may not be prescribed by telehealth or may require an in-person visit under federal and state law. Your provider will discuss any prescription decisions with you during the visit.

Telehealth is not for emergencies. If you are experiencing a medical emergency, call 911 or go to the nearest emergency department.

Telehealth visits are billed the same as in-office visits. JTS Medical is a fee-for-service practice; payment is due at the time of service unless the visit is being billed through PIP or workers' compensation. See our Financial Policy.

By proceeding with a telehealth visit, you acknowledge that you have read and understood this document, have had an opportunity to ask questions, and consent to receive care via telehealth under the terms described above.