Telehealth Consent & Patient Agreement

Last updated August 24th, 2024

Thank you for choosing to be part of our community at Advanced Practice Nursing Specialists, LLC (“we,” “us,” and “APNS”). This “Telehealth Informed Consent” informs the patient (“patient,” “you,” or “your”) concerning the treatment methods, risks, and limitations of using a telehealth platform, and should be read in conjunction with the Terms of Use (“Terms”) for the website (“Site”).

Telehealth

Telehealth includes:

Electronic transmission of medical records, photo images, personal health information or other data between a member and a healthcare provider;
Interactions between a member and healthcare provider via audio, video, and/or data communications; and
Use of output data from medical devices, sound, and video files.

Services Provided

Telehealth services offered by Advanced Practice Nursing Specialists, LLC, a subsidiary of Another Way Holdings, LLC, a Las Vegas, Nevada corporation and affiliated subsidiaries (collectively, “Group”), and the Group’s engaged providers (our “Providers” or your “Provider”) may include a patient consultation, diagnosis, treatment recommendation, prescription, and/or a referral to in-person care, as determined clinically appropriate (the “Services”).

Your Provider will be licensed in the state where you are located at the time of your consultation or otherwise meet a professional licensure exception under applicable state law, and will establish a provider-patient relationship in accordance with the laws and rules in the applicable state. At the time of service, the patient will complete the appropriate intake on which the patient will declare the state they are physically located in at that time, and the system will verify the provider is also licensed in that state.

Electronic Transmissions

The types of electronic transmissions that may occur using the telehealth platform include, but are not limited to:

Appointment scheduling
Completion of medical intake forms
Exchange and review of patient medical intake forms, patient health records, images, diagnostic and/or lab test results via asynchronous communications
Two-way interactive audio in combination with store-and-forward communications between you and your Provider
Two-way interactive audio-video interaction between you and your Provider
Review and treatment recommendations by your Provider based upon output data from medical devices and sound and video files
Delivery of a consultation report
Prescription refill reminders
Other electronic transmissions for the purpose of rendering clinical care to you

Expected Benefits

Improved access to care by enabling you to remain in your preferred location while your Provider consults with you.
Convenient access to follow-up care. If you need non-emergent follow-up care, contact your Provider via the messaging portal of your APNS account or email us at info@apnshealth.com.
More efficient care evaluation and management. APNS strives to respond to all clinical questions as soon as possible but does not guarantee specific response times.

Service Limitations

The primary difference between telehealth and direct in-person service delivery is the inability to have direct, physical contact with the patient. Some clinical needs may not be appropriate for a telehealth visit, and your Provider will make that determination.
OUR PROVIDERS DO NOT ADDRESS MEDICAL EMERGENCIES. If you believe you are experiencing a medical emergency, dial 9-1-1 and/or go to the nearest emergency room.
Our Providers are an addition to, not a replacement for, your local primary care provider. Responsibility for your overall medical care should remain with your local primary care provider.
Group does not have any in-person clinic locations.

Recognition of Services

Only one (1) new medical concern can be addressed per visit.
Visits are limited to 15 minutes.
Not all medical concerns can be addressed via telehealth.
Medical service provided does not always come in the form of a prescription. The practitioner has full discretion in deciding if a medication is appropriate and necessary for a condition.
NO CONTROLLED SUBSTANCES ARE PRESCRIBED. NO EXCEPTIONS.
A video encounter may be required for a visit, and patients must ensure they have a stable internet connection.
Be in a quiet place during your appointment.
Ensure your technology is ready before your appointment, as time will not be extended for technical issues.

Security Measures

The electronic communication systems used by APNS incorporate network and software security protocols to protect patient confidentiality, comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and ensure the integrity of data.

Possible Risks

Delays in evaluation and treatment due to equipment or technological failures.
Transmission quality may affect service quality.
Inadequate data transmission may necessitate a rescheduled telehealth consult.
Breaches of privacy due to security protocol failures (rare).
Incomplete medical records may lead to adverse drug interactions or clinical errors.

Patient Acknowledgments

I acknowledge and understand the following:

I will be given an opportunity to select a provider, or I can elect to visit the next available provider.
APNS displays on its website the identity and professional credentials of all treating providers, available for the patient to review prior to selecting a provider.
If the provider was not specifically selected by the patient, the patient is still able to identify the provider responsible for their care and review that provider’s professional qualifications and licensure information.
In case of a medical emergency, I must dial 9-1-1.
I may choose to seek in-person services as an alternative to telehealth.
I have the right to withhold or withdraw my consent for telehealth at any time.
I am entitled to confidentiality protections under federal and state laws.
Telehealth may involve electronic transmission of personal health information to other health practitioners, including out-of-state practitioners.
Dissemination of identifiable images or information from the telehealth visit will not occur without my consent.
I agree to hold Group and my Provider harmless for any delays caused by technical failures.
Some Services may involve tests conducted at other locations.
I will be informed if other persons are present during my telehealth visit.
My Provider will explain my diagnosis, risks, and treatment options.
I have the right to request a copy of my medical records.
I must provide my Provider with a complete, accurate, and current medical history.
Prescriptions are not guaranteed and are issued at the Provider’s discretion.
My Provider reserves the right to deny care if the Services are misused or deemed medically or ethically inappropriate.

By engaging in this service, I acknowledge that I have carefully read, understood, and agreed to the Terms of this “TELEHEALTH INFORMED CONSENT” and consent to receive the Services. I understand that by clicking the acceptance box, I am signing this Informed Consent electronically, and that (a) I have read this Informed Consent carefully, (b) I understand the risks and benefits of telehealth, and (c) I have the legal capacity to provide this consent for myself and/or a minor under applicable federal and state laws.

Contact

Email: info@apnshealth.com
Address: Advanced Practice Nursing Specialists, LLC, 9205 W Russell Rd, Suite 305, Las Vegas, NV 89148

Telehealth Consent