Online Consultation Consent Form

Telehealth Consultation Consent

I understand and confirm that I agree that the doctor may engage with me via a telehealth consultation. I understand that the consultation will be done via video / internet conferencing technology.

The purpose of the telehealth consultation is to assess and treat my condition, subject to the information I provide. I understand that the doctor may not be able to perform a physical examination during a remote consultation, and that this may limit the diagnostic and therapeutic options available.

I confirm that I will provide accurate and complete information about my health, including current medications, allergies, and relevant medical history.

Information storage and privacy

I understand that information shared during the consultation, including any photographs I may share, will be kept confidential and stored in accordance with the Protection of Personal Information Act (POPIA). My information will not be shared with third parties without my written consent, except as required by law.

Recording

I understand that the consultation will not be recorded unless I have given specific written consent for that recording.

Limitations

I understand that telehealth has limitations, and that I may need to attend an in-person consultation if a physical examination, procedure, or biopsy is required. I understand that emergency cases should be directed to the nearest emergency department, not via telehealth.

Fees and bookings

I understand that consultation fees apply, and that fees are payable at the time of booking confirmation. Bookings are confirmed within 12–48 hours of submission.

Acknowledgement

By proceeding to a booking, I confirm that I have read, understood, and agreed to the terms above.