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INFORMED CONSENT FOR TELETHERAPY My Hope Therapy Services LLC John Miguel, LCSW Name Date of Birth 1. Unless we explicitly agree otherwise, our teletherapy exchange is confidential. Any personal information
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How to fill out informed consent for tele-formrapy

01
To fill out an informed consent for tele-therapy, follow these steps:
02
Begin by reading the informed consent form thoroughly. Make sure you understand all the information provided.
03
Fill in your personal information, including your name, contact details, and any relevant identification information.
04
Provide a brief description of your mental health concerns or reasons for seeking tele-therapy.
05
Review and acknowledge the specified tele-therapy services being offered. Make sure to understand the limitations and potential risks associated with remote counseling.
06
Indicate your preferred communication methods, such as video calls, phone calls, or messaging platforms.
07
Read and sign the consent statement, indicating that you understand and agree to the terms and conditions outlined in the informed consent form.
08
If applicable, provide emergency contact information that can be used by the therapist in case of any urgent situations or crises.
09
Ensure that you have filled out all the required fields and signed the form properly.
10
Keep a copy of the informed consent form for your records.
11
Submit the filled-out form to your therapist or the designated contact person through the provided channels.

Who needs informed consent for tele-formrapy?

01
Anyone opting for tele-therapy services needs to provide informed consent. This includes:
02
- Individuals seeking mental health support remotely
03
- Patients engaging in remote counseling or therapy
04
- Clients utilizing tele-therapy as an alternative to in-person sessions
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Informed consent for tele-therapy is the process by which a patient provides permission and understanding of the potential risks and benefits associated with receiving therapy services via telecommunication technology.
Both the therapist providing tele-therapy services and the patient receiving these services are required to file informed consent.
Informed consent for tele-therapy can be filled out by both the therapist and the patient, detailing their understanding of the tele-therapy process, potential risks, and benefits.
The purpose of informed consent for tele-therapy is to ensure that the therapist and patient both understand and acknowledge the risks and benefits associated with tele-therapy services.
Informed consent for tele-therapy must include information about the therapist's qualifications, treatment methods, confidentiality policies, and potential risks of tele-therapy.
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