In rare instances, security protocol could fail causing a breach of privacy of personal medical information d | I understand the benefits of the telemedicine consultation such as Improve access medical care by enabling a patient to remain in their home, more efficient medical evaluation and access to expertise from distant specialist |
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I agree to give my consent by ticking the below box knowingly, freely and voluntarily and agree to bind by its terms | Delays in medical evaluation and treatment could occur due to deficiencies or failure of equipment c |
I have been provided with enough information in a language that I can understand, to make an informed decision and I agree to have the Telehealth consultation Services.
poor resolution of images to allow appropriate decision making by the consulted physician b | I understand the risks, consequences, benefits, and alternatives of the telemedicine consultation |
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I understand I may withhold or withdraw consent to teleconsultation at any time without affecting my right to future care or treatment | Information transmission may not be sufficient e |
I accept the fact that in case this statement is untrue, neither this hospital nor the doctors are responsible for the caused consequences.