Telehealth consent form

Video consultations

1. About consultations by video To read and agree to · required A video consultation lets your physiotherapist assess and treat you without you travelling. Some things cannot be assessed by video, and your physiotherapist may ask you to come in person. Please join from a private, well-lit place with room to move, and keep your phone nearby in case the video drops. The call is not recorded. If you feel unwell or have an emergency during the call, your physiotherapist will ask where you are so help can be sent.
2. A phone number we can call if the video drops Short answer · required
3. I agree to consultations by video Tick box · required

Signature

1. Your full name Short answer · required
2. Date Date · required

Signature

The patient signs on screen, on their phone or at the front desk, and the signed copy is kept on their file.