University Plaza Family Practice

INFORMED CONSENT FOR VIRTUAL MEDICAL CARE WITH UNIVERSITY PLAZA FAMILY PRACTICE PHYSICIAN

Just like online shopping or email, Virtual Medical Care has some inherent privacy and security risks that your health information may be intercepted or unintentionally disclosed. The doxy.me platform we have chosen to use does not retain any of your personal data. However, depending on your browser privacy settings, doxy.me may install cookies on your computer which indicate that you used the service. The content of the conversation you have with the physician will be not be recorded. Your physician will take notes in your secure electronic record as they would have done at an office visit.

We want to make sure you understand this before we proceed.

In order to improve privacy and confidentiality, you should also take steps to participate in this virtual care encounter in a private setting and should not use an employer’s or someone else’s computer/device as they may be able to access your information.

If it is determined you require a physical exam you may still need to be assessed in person. You and your physician can arrange a time to visit the office safely if an exam is required. Do not come to the office without being advised beforehand.

You should also understand that virtual care is not a substitute for attending the Emergency Department if urgent care is needed.

Are you ok to continue?