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Telehealth consultation template

Consent, identity, where the patient is in case of an emergency, and what video could and could not assess.

What it is built on

  • Telehealth practice. Australian Physiotherapy Association, Telehealth guidelines

How to use it: Telehealth Physiotherapy: Video Appointments in the Browser

Before starting

  1. Consent to a video consultation given Tick box
  2. Identity confirmed Tick box
  3. Where the patient is now (for an emergency) Short answer
  4. Emergency contact if needed Short answer
  5. Patient is somewhere private Tick box

Consultation

  1. Subjective Written answer
  2. What was observed on video Written answer
  3. What could not be assessed by video Written answer
  4. Advice and exercises Written answer
  5. Plan, and whether an in-person visit is needed Written answer

A starting point, not clinical advice. Check that it fits your patients, your practice and the rules where you work before you use it.