Get the free Informed Consent for Telepsychology revised.docx

Mary J. Hendrickson, Ph.D. River Valley Psychological Services 5837 221st Place SE, Issaquah, WA 98027 Confidential Voicemail: 4254967897, x 22 Office Phone: 4253910887 FAX: 4253917014Informed Consent

How to fill out informed consent for telepsychology

How to fill out informed consent for telepsychology

1. Start by obtaining a blank informed consent form for telepsychology from a reliable source or organization.
2. Read the form thoroughly to understand all the information that needs to be provided.
3. Fill in the personal information section, including your name, contact details, and date of birth.
4. Provide details about the telepsychology services you will be receiving, such as the type of therapy, duration, and frequency.
5. Verify that you understand the potential risks and benefits of telepsychology by checking the appropriate box or signing where indicated.
6. If applicable, indicate your preference for audio or video sessions and provide specifications regarding the preferred platform or software.
7. Acknowledge any limitations to confidentiality and potential security risks associated with telepsychology.
8. Indicate your agreement to participate in telepsychology services by signing and dating the form.
9. If needed, include the signature of a witness who can confirm that you understood the content of the informed consent form.
10. Return the completed informed consent form to your therapist or healthcare provider through a secure method, such as encrypted email or a secure online portal.

Who needs informed consent for telepsychology?

1. Informed consent for telepsychology is required for anyone who seeks to receive mental health services through remote means, including:
2. - Individuals residing in remote or underserved areas without access to in-person mental health professionals.
3. - Patients who are unable to attend in-person appointments due to physical limitations, mobility issues, or transportation challenges.
4. - Individuals who prefer the convenience and flexibility of receiving therapy or counseling from the comfort of their own homes.
5. - Minors or individuals requiring guardianship who need to receive mental health services remotely.
6. - People who are physically or mentally unable to attend in-person appointments due to medical conditions or disabilities.
7. - Individuals seeking therapy or counseling for specific conditions or concerns, such as anxiety, depression, trauma, or relationship issues, and are open to receiving services through telepsychology.

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What is informed consent for telepsychology?

Informed consent for telepsychology is the process by which a client gives their consent to receive mental health services through technological means.

Who is required to file informed consent for telepsychology?

Both the telepsychologist providing services and the client receiving services are required to file informed consent for telepsychology.

How to fill out informed consent for telepsychology?

Informed consent for telepsychology can be filled out by providing information about the services offered, risks and benefits, confidentiality, and client rights.

What is the purpose of informed consent for telepsychology?

The purpose of informed consent for telepsychology is to ensure that clients are fully informed about the services they will receive, their rights, and any potential risks involved.

What information must be reported on informed consent for telepsychology?

Information such as the types of services offered, the qualifications of the telepsychologist, fees, confidentiality policies, and emergency procedures must be reported on informed consent for telepsychology.