Written Consent

If possible, it is preferable to obtain written consent. CMPA has developed a written consent form that we recommend you use. The signed form should be added to the patient chart. The advantage of this approach is it provides blanket consent” for future video calls.

Verbal Consent

In many situations, it is more practical to obtain verbal consent. A short statement can be read to the patient when booking a video visit or when the video visit begins.

CMPA Sample Verbal Consent

Just like online shopping or email, Virtual Care has some inherent privacy and security risks that your health information may be intercepted or unintentionally disclosed. 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 video visit 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 you want more information, please check the link on our [website/​confirmation email/​etc.]. If it is determined you require a physical exam you may still need to be assessed in person. 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?

Documenting Patient Consent

Patient consent must be documented in the patient’s chart. Below is a sample note you can copy and paste into a chart:

Informed verbal consent was obtained from this patient to communicate and provide care using virtual and other telecommunications tools. This patient has been explained the risks related to unauthorized disclosure or interception of personal health information and steps they can take to help protect their information. We have discussed that care provided through video or audio communication cannot replace the need for physical examination or an in person visit for some disorders or urgent problems and patient understands the need to seek urgent care in an Emergency Department as necessary.