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Telehealth Release Form Template for England and Wales

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Key Requirements PROMPT example:

Telehealth Release Form

"I need a Telehealth Release Form for our mental health practice in Manchester that covers video consultations and messaging services, with specific provisions for recording sessions and handling sensitive mental health data under UK GDPR."

Document background
The Telehealth Release Form serves as a crucial legal framework for remote healthcare delivery in England and Wales. This document is essential when healthcare providers offer consultations, monitoring, or treatment through digital platforms. It ensures compliance with UK healthcare regulations, data protection laws, and professional standards while clearly outlining the scope and limitations of telehealth services. The form includes specific provisions for patient consent, data handling, technical requirements, and service limitations, protecting both healthcare providers and patients in the digital healthcare environment.
Suggested Sections

1. Patient Information: Patient's personal and contact details, including full name, date of birth, address, contact numbers, and email

2. Service Description: Detailed description of telehealth services being provided, including types of consultations and technology platforms used

3. Consent Declaration: Express patient consent for telehealth services, including acknowledgment of risks and limitations

4. Data Protection Notice: Information about how personal data will be processed, stored, and protected in compliance with UK GDPR

5. Technology Requirements: Technical requirements for accessing telehealth services, including minimum internet speeds and device specifications

6. Limitations and Risks: Disclosure of service limitations and potential risks associated with telehealth consultations

Optional Sections

1. Insurance Details: Patient insurance information section, used when services are being billed to insurance providers

2. Emergency Protocols: Specific procedures and protocols for emergency situations during telehealth consultations

3. Recording Consent: Additional consent section for consultation recording and storage of recorded sessions

Suggested Schedules

1. Technical Requirements Schedule: Detailed technical specifications for telehealth access, including supported devices and browsers

2. Privacy Policy: Comprehensive privacy policy detailing data handling practices and patient rights

3. Service Fee Schedule: Detailed breakdown of service fees and payment terms where applicable

4. Emergency Contact Form: Form for recording patient emergency contact information and preferred local emergency services

Authors

Alex Denne

Head of Growth (Open Source Law) @ tiktok³ÉÈ˰æ | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Relevant legal definitions



































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Relevant Industries
Relevant Teams
Relevant Roles
Industries

UK General Data Protection Regulation (UK GDPR): Primary data protection legislation in the UK post-Brexit, governing how personal health data must be collected, processed, and stored

Data Protection Act 2018: The UK's implementation of data protection standards, working alongside UK GDPR to provide a comprehensive data protection framework

Privacy and Electronic Communications Regulations (PECR): Specific rules for electronic communications, including requirements for electronic marketing and cookies in telehealth platforms

Health and Social Care Act 2012: Framework legislation for healthcare delivery in England, including provisions for digital health services

Medical Act 1983: Fundamental legislation governing medical practice in the UK, including requirements for medical professionals providing telehealth services

NHS Act 2006: Core legislation establishing the framework for NHS services, including provisions relevant to digital healthcare delivery

Health and Care Act 2022: Recent legislation updating healthcare delivery frameworks, including provisions for integrated care and digital health services

GMC Remote Consultations Guidance: Professional guidelines from the General Medical Council specifically addressing standards for remote medical consultations

NHS Digital Standards: Technical and operational standards for digital healthcare services within the NHS framework

Care Quality Commission Regulations: Regulatory requirements for digital health providers, ensuring quality and safety in telehealth services

Consumer Rights Act 2015: Legislation protecting consumer rights in service contracts, including digital healthcare services

Consumer Contracts Regulations 2013: Specific regulations governing distance selling and digital services contracts

Electronic Communications Act 2000: Framework legislation for electronic communications and digital signatures in the UK

Electronic Signatures Regulations 2002: Specific regulations governing the use of electronic signatures in digital documents and contracts

Network and Information Systems Regulations 2018: Cybersecurity requirements for digital service providers, including healthcare platforms

NICE Guidelines on Remote Consultations: Clinical guidelines from the National Institute for Health and Care Excellence specific to telehealth consultations

NHS England Digital-First Primary Care Guidance: Specific guidance for implementing digital-first approaches in primary healthcare settings

Equality Act 2010: Legislation ensuring equal access to services, including requirements for making telehealth services accessible to all users

Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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