Risk of Using Electronic Communications (Email, Texts etc.)

Cardwell Family Practice offers clients the opportunity to communicate occasionally with using electronic means (i.e. email, text).

Transmitting information electronically, however, has a number of risks that clients should consider before communicating personal information electronically and giving consent to the Provider to engage in two -way electronic communications.

These risks include but are not limited to:

  • Email and other electronic communications can be immediately broadcast worldwide and received by both intended and unintended recipients. Email senders can misaddress email. Backup copies of email may exist even after the sender or the recipient has deleted his or her copy.

Conditions for the Use of Electronic Communications

Cardwell Family Practice will use reasonable means to protect the security and confidentiality of electronic communications sent and received. However, because of the risks outlined above, Cardwell family Practice cannot guarantee the security and confidentiality of electronic Communication and will not be liable for improper disclosure of confidential information that is not caused by the Provider’s intentional misconduct. Thus, clients must consent to the use of electronic communication with Cardwell Family Practice.

Expectations for Electronic Communication Electronic communication should only be used by clients for non-urgent matters Cardwell Family Practice will make every effort to read and return emails within 72 business hours.

If a matter is regarding a crisis or imminent risk of suicide, individuals should not use electronic communication. Instead they should call ooo or go to their nearest hospital emergency room.

Client Acknowledgement and Agreement, I acknowledge that I have read and fully understand this consent form. I understand the risks associated with electronic communication between the Provider and me, and consent to the conditions outlined herein. In addition, I agree to the expectations outlined herein, as well as to any other instructions that the Provider may impose to communicate with clients electronically.

Any questions I may have had were answered

 

Parent/Guardian  _________________________________DATE:____________________________

 

Doctor:_________________________________________DATE:_____________________________