AHRQ’s Easy-to-Understand Telehealth Consent Form | Agency for Health Research and Quality

https://www.ahrq.gov/health-literacy/informed-consent-telehealth.html

AHRQ's Easy-to-Understand Telehealth Consent Form

AHRQ has created a sample telehealth consent form (Word, 27 KB) that is easy to understand. The form includes language for healthcare providers that have curtailed in-person visits due to COVID-19. AHRQ has also created how-to guidance for clinicians on how to obtain informed consent for telehealth.

Some States do not require documented informed consent for telehealth, but there are still advantages to using the AHRQ Easy-to-Understand Telehealth Consent Form.

• Clinicians can use the easy-to-understand language from the form when they are having the consent discussion.
• Clinicians can use the form as a checklist to make sure they have covered all the information required by informed consent rules.

Can we use the AHRQ Easy-to-Understand Telehealth Consent Form as is?

No. The AHRQ Sample Consent Form must be adapted before using it.

• Fill in the areas highlighted in yellow.
• Tailor the form. What is unique about your organization and your target audience?
• Put your logo on the form.
• Check with your lawyer before using the form. Laws on informed consent vary from State to State.
• Translate the form into languages your patients are most comfortable reading. Take care that translated materials are not made more complex.

How do we document consent when we're not having the consent discussion face-to-face?

Patients can give their consent verbally at the beginning of their first telehealth visit, and clinicians can document it in the medical record. In addition to verbal consent, a signature can be obtained through your patient portal and the U.S. mail. Guidance on documenting consent is included in the how-to guidance for clinicians.

• You can arrange for patients to be able to virtually sign the consent form in your patient portal, if you have one. Clinicians will have to check whether patients can access the patient portal, and a staff member will have to give them clear directions on how to sign the form.
• If patients cannot use a patient portal, you can mail consent forms (one to sign and return, one for the patient to keep) and a stamped return envelope. Clinicians can ask patients to sign and mail back the form.

How do we get copies of these materials?

Select the links below.

• AHRQ Easy-to-Understand Telehealth Consent Form (Word, 27 KB)
• How to Obtain Consent for Telehealth