TELEPSYCHIATRY INFORMED CONSENT

I understand that telepsychiatry involves consultation via video/audio/text using digital platforms as per Telemedicine Practice Guidelines (India). Services may include assessment, counselling, and prescription.

I voluntarily consent to receive psychiatric consultation through telemedicine. I understand I may withdraw consent at any time.

I confirm that I have disclosed my identity truthfully. I understand the doctor will also identify themselves with credentials.

My medical information will be kept confidential and handled as per applicable Indian laws. I understand there are risks of data breach despite reasonable safeguards. I will ensure privacy at my location.

I understand that:

• Physical examination is limited.

• Technical issues may disrupt consultation.

• Diagnosis/treatment may be based on information I provide.

I understand teleconsultation is not for emergencies. In crisis, I will contact local emergency services or visit the nearest hospital.

I understand that:

• Prescriptions will follow Telemedicine Guidelines drug categories.

• Certain medications may not be prescribed without in-person evaluation

I understand my rights under the Mental Healthcare Act, 2017, including confidentiality, informed consent, and access to records.