Sample Forms and Policies
It is essential to have up-to-date policies, procedures and forms to support your telehealth program. This section contains samples that can be used to help you develop your own customized documents.
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Sample Telemedicine Policy
Policies are a set of rules put in place by a facility to ensure safety and promote staff compliance. Telemedicine programs should have good policies and procedures in place to serve as a guide for staff and ensure patient safety. The sample policy provided illustrates the procedures in place for telemedicine related to psychiatric services.
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Sample Patient Consent Form
The following sample consent form is for a telemedicine program. A consent form is a detailed explanation of a procedure or process in which one gives authorization for or declines a procedure after a discussion of risks and benefits with the physician.