I, {printName}, voluntarily elect to participate in remote mental health treatment sessions through the aid of interactive audio, video, web- based, video conferencing, also known as telehealth.
I understand that telehealth is a relatively new and increasingly utilized format with which to deliver mental health treatment. Benefits of mental health treatment via telehealth include increased access to mental health care, such as in rural areas and during communicable disease outbreaks. Telehealth improves efficiency, decreases costs for the health care system and results in equal and sometimes better outcomes than in -person mental health treatment.
I understand that, as in any online communication, there is an inherent risk of the loss of confidentiality. However, the platform being used for my care uses a HIPAA-compliant video platform that protects the privacy of clients and the confidentiality of personal health information. The platform uses end-to-end encryption, securing any data in transit and rest, and all systems and policies are protected by a stringent data security access policy.
In keeping with Vermont statutes and to further assure confidentiality of these sessions, neither my mental health practitioner nor I will record these telehealth sessions.