Telehealth Informed Consent

TELEHEALTH INFORMED CONSENT explains the telehealth/ telemedicine provision of medical
and mental health information provided by any means other than a face-to-face visit.
Please read this form carefully as the terms telemedicine and telehealth are now
frequently in the media. This is a form with two parts that you would sign

  1. your agreement for electronic communication with Dr.
    Cordoba or his staff.
  2. that you have read and understand the Optional National
    Emergency Crisis Language. Any questions should be directed to Dr. Cordoba.