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TAME Psychology Clinic Department of Psychological & Brain Sciences College of Liberal Arts Consent to Telebehavioral Health (Audio only or AudioVideo) Services Adult Client or Parent/Guardian Consent By

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How to fill out consent to telebehavioral health

01

Review the consent form provided by the telebehavioral health provider.

02

Fill in your personal information accurately, including your name, date of birth, contact information, and insurance details.

03

Read through the terms and conditions of the telebehavioral health services and ensure you understand them.

04

Sign and date the consent form to indicate your agreement to participate in telebehavioral health services.

05

Submit the completed consent form to the telebehavioral health provider either electronically or in person.

Who needs consent to telebehavioral health?

01

Anyone who wishes to participate in telebehavioral health services will need to fill out a consent form.

02

This includes individuals seeking therapy, counseling, psychiatric services, or any other form of mental health support through telecommunication platforms.

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What is consent to telebehavioral health?

Consent to telebehavioral health is the agreement given by a patient to receive mental health services via telecommunications technology.

Who is required to file consent to telebehavioral health?

Any patient seeking telebehavioral health services is required to file consent.

How to fill out consent to telebehavioral health?

Consent to telebehavioral health can be filled out either electronically or on paper, and typically requires the patient's signature.

What is the purpose of consent to telebehavioral health?

The purpose of consent to telebehavioral health is to ensure that the patient understands and agrees to receive mental health services online.

What information must be reported on consent to telebehavioral health?

Consent to telebehavioral health must include details about the patient's rights, treatment options, confidentiality, and potential risks of telebehavioral health services.

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