The Children’s Clinic is utilizing the platform of doxy.me for telemedicine services. In order to schedule a telemedicine visit please contact our clinic at 935-6012 to set up an appointment.
Currently, most insurance companies are waiving any caregiver fee for telemedicine services, but this could change in the next few weeks and we will update this page at that time.
See Below for The Children’s Clinic Terms of Service for Telemedicine
Telemedicine Acknowledgement Form
- I understand that my health care provider, The Children’s Clinic, has recommended to me that I engage in a Telehealth appointment.
- My health care provider has explained to me how the telehealth technology will be used to connect me with a provider. Telehealth appointments may be conducted by videoconferencing, video images, still images or by telephone conference. I understand that this appointment will not be the same as a direct patient/health care provider visit due to the fact that I will note be in the same room as my health care provider.
- I understand there are potential risks to this technology, including interruptions, unauthorized access and technical difficulties. I understand that my health care provider or I can discontinue the telehealth appointment if it is felt that the videoconferencing connections are not adequate for the situation. I understand that I can discontinue the telehealth appointment at any time.
- I understand that my healthcare information may be started with other individuals for scheduling and billing purposes. The above mentioned people will all maintain confidentiality of the information obtained. I further understand that I will be informed of their presence during the consultation and thus will have the right to request the following: (1) omit specific details of my medical history/physical examination that are personally sensitive to me; (2) ask non-medical personnel to leave the telehealth examination room; and/or (3) terminate the telehealth appointment at any time.
- In an emergency situation, I understand that the responsibility of the telehealth provider may be to direct me to emergency medical services, such as the emergency room. The telehealth provider’s responsibility will end upon termination of the telehealth connection.
- I understand that billing for the telehealth consultation may occur from 1) the primary care provider and 2) telehealth provider. Billing is at the discretion of the provider and specific to your insurance company. You are responsible for any fee per your insurance company’s policy.
- I have read the document carefully, and understand the risks and benefits of the telehealth appointment and have had my questions regarding the procedure explained and I hereby consent to participate in a telehealth appointment visit under the terms described herein.