Telehealth Consent Form

This document outlines the risks, limitations, procedures, and responsibilities associated with online counselling and teletherapy services provided by Let’s Broach.

By participating in online sessions, you voluntarily consent to telehealth services under the following terms.

1. NATURE OF TELEHEALTH SERVICES

Teletherapy involves psychological support provided through:

  • video calls,
  • phone calls,
  • online platforms,
  • digital communication systems.

Sessions may occur through third-party platforms.

2. POTENTIAL BENEFITS

Teletherapy may offer:

  • increased accessibility,
  • geographical flexibility,
  • convenience,
  • continuity of care,
  • remote emotional support.

However, online therapy may not be suitable for all individuals or conditions.

3. LIMITATIONS OF TELEHEALTH

Clients acknowledge that telehealth has limitations including:

  • internet disruptions,
  • technological failures,
  • audio/video interruptions,
  • communication delays,
  • reduced observation of non-verbal cues,
  • confidentiality limitations,
  • cybersecurity risks,
  • emergency response limitations.

Online counselling may not be as effective as in-person care for certain conditions.

4. CONFIDENTIALITY & SECURITY RISKS

While reasonable precautions are taken, no internet-based system can guarantee complete confidentiality or security.

Potential risks include:

  • hacking,
  • unauthorized access,
  • software vulnerabilities,
  • accidental disclosures,
  • device compromise,
  • third-party interception.

Clients acknowledge and voluntarily accept these risks.

5. CLIENT RESPONSIBILITIES

Clients agree to:

  • use secure devices,
  • use stable internet connections,
  • attend sessions from private environments,
  • avoid public Wi-Fi where possible,
  • maintain confidentiality on their end,
  • ensure they are physically safe during sessions.

6. EMERGENCY LIMITATIONS

Teletherapy has limitations during emergencies.

Clients acknowledge:

  • immediate intervention may not be possible,
  • therapists may not be physically nearby,
  • local emergency resources may differ internationally.

Clients remain responsible for contacting local emergency services during crises.

7. LOCATION DISCLOSURE

Clients may be asked to disclose:

  • current physical location,
  • emergency contact information,
  • local emergency resources.

This may assist in emergency situations.

8. INTERNATIONAL CLIENTS

International clients acknowledge:

  • laws differ across jurisdictions,
  • local legal protections may vary,
  • emergency support limitations exist,
  • therapy legality is client responsibility.

9. RECORDING POLICY

Sessions are not routinely recorded.

Clients may not record sessions without explicit written consent.

Unauthorized recording is prohibited.

10. INTERRUPTION POLICY

If technical disruptions occur:

  • sessions may pause,
  • reconnect attempts may occur,
  • rescheduling may be necessary.

Therapists are not liable for technology failures outside reasonable control.

11. COMMUNICATION OUTSIDE SESSIONS

WhatsApp and email may be used for:

  • scheduling,
  • reminders,
  • administrative communication,
  • limited support coordination.

These are not emergency-response channels.

12. TERMINATION OF TELEHEALTH SERVICES

Teletherapy may be discontinued where:

  • online care becomes clinically inappropriate,
  • safety risks emerge,
  • repeated technological disruptions occur,
  • legal restrictions apply.

Alternative referrals may be recommended.

13. CONSENT

By participating in online sessions through Let’s Broach, clients voluntarily consent to telehealth services and acknowledge the limitations and risks described above.