Informed Clinical Consent Scheduled Video-Appointment Service

Dear Client,
Please read the following content carefully, verify that all information is correct, and do not hesitate to request further information if anything is unclear.
INFORMED, CLARIFIED AND FREE CONSENT FOR A VIDEO-APPOINTMENT (PURSUANT TO GUIDELINE No. 015/2013 OF THE Directorate-General of Health)

1. Client Identification (details provided at the time of appointment booking — Video-Appointments)

2. Description of the act

•  Video-appointment with audio and video of the client.

3. Objective

• Clinical advice and/or triage, follow-up and guidance of the client regarding their health condition.

4. Benefits

• Remote clinical assessment, with comfort and ease of access.

5. Security

• The electronic systems used incorporate security protocols to protect the confidentiality of your identity and clinical data, and include measures that safeguard and ensure their integrity.

6. Drawbacks

• The situation may not be resolvable by video-appointment and may require a subsequent in-person consultation.
• In particular, for Neurology appointments, neurological assessment in the context of a video-appointment may present diagnostic limitations, namely due to the impossibility of performing a complete neurological examination, which may prevent the identification of relevant clinical signs and does not allow for the definitive exclusion of certain clinical conditions of varying severity.
• Technical difficulties or failure that prevent or interrupt the video-appointment;
• Failure of security protocols resulting in a breach of clinical data privacy;
• Security vulnerabilities attributable to the Client’s device and/or the networks through which the video-appointment connection is established.