Telehealth Informed Consent & Acknowledgement

For purposes of these policies, “PRISM Care,” “we,” “our,” and “provider” refer to PRISM Care, a DBA of PRISM Care PLLC, including its providers, employees, contractors, and authorized representatives.

1. Nature of Telehealth Services

PRISM Care provides healthcare services via secure, HIPAA-compliant synchronous audio and video communication technology in accordance with applicable federal law, Medicare requirements, and Nevada regulations. A provider–patient relationship may be established via telehealth when appropriate clinical standards are met.

2. Limitations of Telehealth

You acknowledge telehealth has inherent limitations, including the inability to perform a comprehensive physical examination, reliance on patient-reported information, and potential for incomplete clinical data. These limitations may impact diagnostic accuracy and treatment outcomes.

3. Patient Responsibilities

You confirm you are physically located in Nevada at the time of service, will provide accurate and complete information, will participate from a safe and private setting, and will provide home-monitored data (e.g., blood pressure, weight, temperature) when available.

4. Consent for Evaluation and Treatment

You consent to medical evaluation, diagnosis, treatment planning, prescribing when clinically appropriate, ordering of labs/diagnostics, and care coordination/referrals.

5. Privacy and Confidentiality

Telehealth encounters are conducted using HIPAA-compliant systems. Your health information will be used and disclosed for treatment, payment, and healthcare operations as permitted by law.

6. No Guarantee of Outcomes

Medicine is not an exact science. No guarantees are made regarding outcomes, and results may vary based on individual factors.

7. Emergency Situations

PRISM Care does not provide emergency medical services. If you experience symptoms such as chest pain, shortness of breath, neurological changes, severe pain, or bleeding, you must call 911 or seek immediate in-person care.

8. Provider Discretion

PRISM Care reserves the right to decline evaluation or treatment, terminate a visit, or refer you for in-person or emergency care when telehealth is not appropriate or safe.

9. Technical Risks

You acknowledge potential connectivity issues or transmission delays and agree to reconnect or reschedule if necessary.

10. Liability Acknowledgment

You agree to hold PRISM Care harmless from claims arising from telehealth limitations or reliance on information you provide, except in cases of gross negligence or willful misconduct.

11. Consent Confirmation

By proceeding with services, you confirm you have read, understand, and consent to telehealth care.