Mississippi Telehealth Informed Consent
Effective date: August 26, 2026
Last updated: August 26, 2026
Please read this consent before receiving telehealth services from Connect Care Medical LLC.
What telehealth is
Telehealth uses electronic communications to provide healthcare when the patient and provider are in different locations. It may include real-time audio/video, telephone when clinically and legally appropriate, secure messages, remote monitoring, or review of information transmitted electronically.
Services and clinical limits
Telehealth may be used for clinically appropriate evaluation, follow-up, condition management, medication management, review of records or test results, education, and treatment planning within the provider's authorized scope.
Telehealth is not appropriate for every condition. A remote encounter may limit physical examination, vital signs, testing, or observation. The provider may decline or stop a telehealth encounter and require records, laboratory or diagnostic testing, imaging, an in-person examination, specialist care, urgent care, or emergency care.
Patient identity and physical location
At each encounter, I agree to provide accurate identity information, my current physical location, a telephone number for reconnection, and information about other people present. I understand that care is considered rendered where I am physically located and that the provider must be authorized to practice there. Connect Care Medical may not treat me if authorization or clinical requirements are not met.
Benefits and Risks
Potential benefits include convenience, reduced travel, improved access, continuity, and timely care.
Potential risks include প্রযুক্তি, internet, audio, or video failure; delay or interruption of care; limitations of a remote examination and possible incomplete or inaccurate assessment; need for later in-person care or testing; unauthorized access or disclosure despite reasonable safeguards; and risks associated with electronic communications and information transmission. No electronic system can be guaranteed completely secure.
Privacy and The Medical Record
Connect Care Medical will use reasonable privacy and security safeguards and will document the encounter in the medical record. The Notice of Privacy Practices explains how medical information may be used and disclosed. I will participate from a private location when reasonably possible, protect my account credentials, and tell the provider who else can see or hear the encounter.
My Responsibilities
I agree to provide complete and accurate symptoms, medical history, medications, allergies, recent treatment, pregnancy status when relevant, and other information requested. I understand that inaccurate or withheld information may make care unsafe. I agree to follow instructions for medication, testing, referral, follow-up, or escalation of care.
Prescriptions and Controlled Substances
Telehealth does not guarantee a prescription. The provider will prescribe only when medically appropriate and legally permitted, based on adequate clinical information and the provider's scope and judgment. Records, testing, an in-person examination, Prescription Monitoring Program review, or other requirements may apply.
Emergencies
CONNECT CARE MEDICAL'S ROUTINE TELEHEALTH SERVICE IS NOT AN EMERGENCY SERVICE. If I may be experiencing an emergency, I will call 911 or go to the nearest emergency department.
Mississippi APRN Disclosure
Care provided by an advanced practice registered nurse (APRN), including a certified family nurse practitioner, remains limited to that APRN's education, certification, population focus, competence, Mississippi authority, prescriptive authority, and collaborative requirements. Telehealth does not expand scope of practice.
For an APRN caring for a patient physically located in Mississippi, Connect Care Medical must maintain the Mississippi APRN requirements applicable to that practice, including an approved physical Mississippi practice site, compatible collaborating physician, and collaborative agreement.