Fraser

604-301-9955

Grandview

604-434-2222

Kingsway

604-874-5555
Virtual Platforms Consent

Virtual Platforms Consent

Please submit the form at the bottom of this page to consent to virtual care:

Consent to use virtual platforms at Pacific Medical

(Telephone, video, text messages and email communication)

The physician will use reasonable means to protect the security and confidentiality of your medical information. However, there are always risks of information interception that cannot be controlled by the physician. There are also limitations to virtual care for the diagnosis and treatment of some medical issues.

Risks of using virtual care tools:

  1. Telephone calls and emails may be intercepted by a third party, especially in the use of unencrypted devices (phones and emails usually do not have encryption).
  2. Even after the sender and recipient have deleted copies of electronic communications, back-up copies may exist. In addition, information may be lost due to technical failures associated with your software or internet service provider.
  3. Emails and text messages have a higher risk of being misdirected, resulting in being received by unintended and unknown recipients.
    • To mitigate this risk, please ensure your email and phone number is up to date before your appointment
  4. In some cases, virtual care is not an appropriate substitute for in-person examination, or for attending the Emergency Department if needed.
    • Your physician may request that you come in-person for examination before proceeding with diagnosis and treatment
    • We encourage patients to request a physical exam if you are not comfortable with a virtual assessment

Your responsibilities:

  1. If your electronic communication requires a response, it is your responsibility to followup to ensure the intended recipient received the communication.
    • We recommend only sending emails that do not require a response, eg. sending pictures for a future appointment
  2. Never use email for medical emergencies or for communications that require a timely response. We recommend calling our office to book an appointment, or if appropriate visiting an urgent care centre, emergency department or calling 9-1-1 if there is an urgent medical problem.
  3. Our Medical Office Assistants (MOAs) receive all emails – we recommend against asking medical questions or putting confidential information in your emails.
  4. Keep us up to date with your correct email address, telephone number and mailing address.
  5. Inform the physician of any types of information you do not want sent via electronic communication (eg. voicemails, email) in writing. (Eg. mental health matters, sexually transmitted disease, substance use)
  6. You must obtain the physician’s consent prior to making any recording of the virtual care encounter.
I
(the patient) acknowledge the above risks and agree to abide by my responsibilities when engaging in virtual care, such as email, telephone calls, videoconferencing and text messages. I understand that I may, at any time, withdraw from using electronic communication upon providing written notice.

By typing your name as your signature and submitting this form, you are consenting to the terms on this page. A copy of the completed form will be emailed to you.