Telehealth Consent Form

All 5 questions, ready for patients to answer on their phone. Built for telehealth and virtual visit practices.

Questions: 5
Page: 1
Time: about 1 min

E-signature

Your practice

I understand the benefits and risks of telemedicine, and I agree to participate in telemedicine services.

Full Name

Date of Birth

Today's Date

Signature

Live preview. Tap through it like a patient.

Who it is for

Telehealth and virtual visit practices
Remote mental health and counseling services
Teledermatology and specialist consultations
Follow-up visit virtual care programs

Formisoft for Mental Health Formisoft for Dermatology

What's inside

Before you publish: Add your practice-approved consent wording before publishing.

I understand the benefits and risks of telemedicine, and I agree to participate in telemedicine services.Toggle · Required
Full NameText · Required
Date of BirthDate · Required
Today's DateDate · Required
SignatureE-Signature · Required

From form to a ready patient

01
Make it yours
Reword, reorder, or add to the Telehealth Consent Form, and add your logo.
02
Patients finish it at home
A secure link by text or email, filled out on their phone before the visit. No app.
03
Your team sees who is ready
Each visit shows as ready once its forms are in. Answers land on the patient record.

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Questions

Responses are encrypted, only your team can see them, and a BAA is included.

Yes. You can add, remove, reorder, or reword any of the 5 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

Yes. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Send it before the visit, so patients arrive ready.

Book a short call and we will set up the Telehealth Consent Form for your practice, ready to send before the next visit.

BAA included · We set up your front desk

Use this template