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