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DECCA, LLC Telemedicine/Telehealth Consent PATIENT NAME: ___ DATE OF BIRTH: ___ PHYSICIAN NAME: ___ DATE CONSENT OBTAINED: ___ The purpose of this form is to obtain your consent for a Telehealth visit
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Obtain necessary information about McLeod school-based telehealth program requirements and procedures.
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Complete the application form accurately and completely.
03
Submit any required documentation, such as medical records or consent forms.
04
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Follow up with program staff as needed and provide feedback on the experience.

Who needs mcleod school-based telehealth program?

01
Students who are unable to access traditional healthcare services
02
Students who require ongoing medical care or monitoring while at school
03
Students with chronic health conditions that require regular check-ups
04
Schools with limited access to healthcare facilities in their area
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McLeod school-based telehealth program is a program that provides telehealth services to students in schools.
The school administration or designated healthcare providers are required to file the McLeod school-based telehealth program.
To fill out the McLeod school-based telehealth program, the designated individuals need to provide information about the services offered, number of students served, outcomes, and any challenges faced.
The purpose of McLeod school-based telehealth program is to provide convenient access to healthcare services for students without needing to leave the school premises.
The information that must be reported on McLeod school-based telehealth program includes services provided, number of students served, outcomes of the program, and any challenges encountered.
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