Tele Consult Terms

I, the Patient/ Parent/ Guardian hereby agree:

 

  1. To be serviced by the Practitioner from this Practice, with whom I have established a practitioner-patient relationship, or as a new patient, by means of electronic media (Zoom or similar; and/or by telephone and/or by WhatsApp Call or FaceTime call )as authorised by the Health Professions Council of South Africa (HPCSA) for the period of the Covid-19

 

  1. I understand that this platform will be used to render healthcare services to me, and that the usual consent processes will be followed  (i.e. I will be informed of my health status, as well as the benefits, risks and implications of the care). I understand that I can opt out of receiving care, at any stage, but acknowledge that it may not be in my best interest and I therefor release the Practitioner form being legally liable for

 

  1. There is no subscription required when using the electronic platforms mentioned above, such as costs for the Applications (‘Apps’) used, but I understand that I will carry my own costs of any infrastructure and/or running costs associated with suchservice being rendered

e.g. the data used, telephone and/or computer, etc.

 

  1. That the Practitioner may encourage me to present myself for a face-to-face consultation at a healthcare facility close to me, if he/she is in doubt that the telehealth consultation is in my best interest, provided that it would be safe for me, the Practitioner and others, to do

 

  1. That I will be billed for a consultation at the rate of R900 for 25 minutes or any part thereof. I also understand that, due to the nature of the current pandemic, that the Practitioner may have to give urgent attention to their patient, and/or have to move my appointment to a later or earlier time or day.

 

  1. That my medical scheme may or may not cover the costs of this care. I undertake to cover any shortfall that my scheme does not cover, which may be the full amount. However, I understand that the HPCSA allows such care during the time of the Covid-19 Pandemic, and that certain services must be funded by my scheme in

 

  1. To record-keeping of the sessions, i.e. the Practitioners notes, which are required by law, and with my prior consent, to the recording of the live sessions as video and sound

 

  1. That the service may have limitations relating to technology, such as data and internet failures (e.g. dropped calls or badreception).

 

  1. That, although the Practitioner will adhere to the existing rules relating to confidentiality:
    1. I understand that I must take the necessary precautions at home to ensure my confidentiality during telehealth service
    2. I understand that, should I want a family member, caregiver, parent or other person to attend the sessions with me (in person or through remote internet connection), I will provide my written consent to such attendance prior to the consultation. I understand that without this, should such a person be in attendance, the engagement may be cancelled or
    3. I understand that, and agree that, should the practitioner believe that I may have been exposed to Covid-19 and/or do have Covid-  19, he/she would refer me for tests, and I understand that the results of such tests must be reported, by law, to the NICD – National Institute of Communicable

 

I, therefore, freely and voluntarily consent to this service, and I understand the implications thereof, including the costs related to it.

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