Telehealth:

I understand that:

• My provider at Altitude Pediatrics recommends I engage in a telehealth appointment that will be conducted using video conferencing or telephone conference.
• This appointment is not the same as a direct patient/health care provider visit due to the fact that I will not be in the same room as my health care provider.
• There are potential risks to this technology, including interruptions, unauthorized access, and technical difficulties. I understand that my healthcare provider or I can discontinue the appointment at any time if the connections are not adequate.
• My healthcare provider may share information with other individuals for scheduling and billing purposes. I also understand that all information provided is confidential.
• Chronic conditions and management can often be done over telehealth (ADHD, asthma, anxiety, and depression). Other consults related to development, simple rashes, and behavior can also be done via telemedicine.
• Some parts of the exam, including physical tests, require in person physical exams. I understand that antibiotics typically will NOT be prescribed via telehealth visits. I also understand that well checks cannot be done via telehealth.
• In an emergency situation, it is my responsibility to take the advice of the healthcare provider to obtain further evaluation either in the clinic or at the emergency department upon the termination of the telehealth conversation.
• Many insurance companies are now covering provider telephone advice calls and telemedicine visits. However, I also understand that it is my financial responsibility to contact the insurance company prior to telehealth conversations regarding billing and coverage.
• Billing for telehealth consultations is still placed in a schedule for your provider during specific office hours. Telehealth visits will be billed to your insurance and copays will be collected when appropriate.

SMS Communication:

I understand that:

• Our medical office offers the option to communicate with patients via SMS (text messaging) for appointment reminders, health updates, and other relevant information.
• I must provide written permission to receive text messages, that I can revoke or withdraw permission at any time, and that Altitude Pediatrics does not condition treatment, payment, benefit eligibility, or enrollment activities on providing or refusing consent for text messaging.
• SMS messages may include appointment reminders, health updates, and other relevant information.
• Standard text messaging rates may apply as per my mobile carrier’s plan.
• I can opt-out of receiving SMS messages at any time by notifying the medical office in writing or by following the opt-out instructions provided in the messages.
• SMS messages are not a secure form of communication, and there is a risk that messages could be intercepted or read by unauthorized individuals.