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Pathways Transition Programs, Inc.

Informed Consent for Telemental Health

Telemental Health Service Delivery 

Telemental Health (TMH) is the use of telecommunications technology by a clinician to deliver real-time care when they cannot be physically present with a client. In this circumstance, TMH may be used to deliver a variety of Pathways Transition Programs, Inc. (PTP) services including, individual therapy, family therapy, psychiatric assessments, medication management, crisis intervention, follow-ups, skills development, and training sessions.

Informed Consent for Telemental Health Services 

Technologies
  • Clinicians may connect by text, email, or telephone, or video.
  • Most often, PTP clinicians will conduct TMH appointments using Google Meet or VSee. These are free, online interactive video conferencing tools.

Security & Privacy
  • All existing privacy laws apply to TMH consultations.
  • Google Meet and VSee security protections meet or exceed the technical requirements specified by the HIPAA security rule.
  • PTP clinicians will not record video or phone sessions without your permission. Clinical notes from consultations will be added to your medical record and you have legal access to copies of these records.
  • PTP will not share any information gathered from your TMH appointments with other entities without your consent.

Confidentiality
  • Reasonable and appropriate efforts have been made to eliminate any confidentiality risks associated with TMH consultations.
  • Under federal and Georgia state law, all existing confidentiality protections apply to any information you share with your
  • clinician during all TMH appointments.

Your Rights
  • TMH services are voluntary. You may withdraw consent for services delivered in this manner at any time without affecting your right to future care or eligibility for other programs.
  • You have the right to ask questions about any procedures or techniques used by your clinician.
  • You have the right to learn about alternative methods of care.

Understandings
  • TMH appointments will not be exactly the same as face-to-face sessions since you and your clinician are not present in the same room.
  • Clinicians are usually located in a PTP office or in a home office. Please find a private, quiet setting in your home, office, school, etc., for your appointment.
  • At the beginning of your appointment, you and your clinician will discuss how to re-connect if the video conferencing or telephone connection is interrupted or dropped.
  • You will use your own device to connect for appointments and PTP is not responsible for its performance or the quality of your Internet connection.
  • If your minor child is the client, as his or her parent/guardian, you will be available by telephone or text during your child's TMH sessions.
  • If there is an emergency during the session, the clinician will call emergency services and your emergency contacts.

Risks
  • While Google Meet and VSee are extremely secure conferencing tools, there is still a very small possibility of unauthorized access that could affect my confidentiality.
  • Communications technology can be subject to interruption and technical difficulties.
  • You or your clinician may discontinue an appointment at any time if either of you feels the video conference, text, email, or telephone connection is not sufficient for the situation.

Benefits
  • TMH provides increased appointment scheduling flexibility.
  • TMH eliminates travel time and expense.
  • TMH reduces the time you are unable to work or care for other family members.
  • TMH eliminates an office waiting room.
  • During this time of pandemic, TMH reduces your exposure to potential contagions; you can remain in your home to limit contact with others.

​PTP staff explained how videoconferencing, text, email, and telephone procedures will be used. You have had the opportunity to ask questions and they have been answered. You understand the written information provided on this webpage and you consent to TMH services when you join the meeting using the link sent to you by your clinician.

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​Pathways Transition Programs, Inc.     120 E Trinity Place, Decatur, Georgia 30030     404.378.2300     © 1991 — 2020   All rights reserved.
  • Home ∨
    • COVID-19 Message
    • Staff Intranet
  • About ∨
    • Staff
    • Locations
    • Insurance
    • Careers
    • Contact Us >
      • Records Requests
  • Why Choose Us? ∨
    • Mission, Values, Beliefs
    • Kaleidoscope Model™
  • Service Overview ∨
    • Services
    • State-Funded Programs
    • Appointments >
      • Telemental Health >
        • TMH Informed Consent (English)
        • TMH Informed Consent (Spanish)
    • Hotlines
  • Referrals
  • Community Learning ∨
    • The Village at Pathways
    • Growing Children™