Patient Consent To The Use of Telemedicine
I have read and understand the information provided above regarding telemedicine, have discussed it with my physician or such assistants as may be designated, and all of my questions have been answered to my satisfaction. I hereby give my informed consent for the use of telemedicine in my medical care.
I hereby authorize Pulmonary & Sleep Specialists, P.C. to use telemedicine in the course of my diagnosis and treatment.
Signature of Patient (or person authorized to sign for patient):
If authorized signer, what is your relationship to patient?