Informed Consent for Telehealth Services

Telehealth involves the delivery of mental health services using electronic communications, including video conferencing, telephone, and secure messaging platforms. Anne Rose, LMFT provides psychotherapy services via telehealth to clients located throughout California.

• Convenient access to therapy from the comfort of your home or any private location
• Eliminates travel time and transportation barriers
• Increased scheduling flexibility
• Access to specialized care regardless of geographic location
• Continuity of care during illness, inclement weather, or other circumstances

Telehealth services differ from in-person therapy in important ways. Potential risks and limitations include:

• Technology failures (internet outages, audio/video disruptions) may interrupt sessions
• Confidentiality may be compromised if you are not in a private location during sessions
• Non-verbal cues may be more difficult to observe via video
• Telehealth may not be appropriate for all clinical presentations or crisis situations
• Electronic transmission of information carries inherent, though manageable, security risks

Sessions are conducted using HIPAA-compliant video platforms. You are responsible for ensuring you are in a private, secure location during sessions and that your device and internet connection are reasonably secure.

You should not participate in telehealth sessions from a public location, on an unsecured public Wi-Fi network, or in a setting where others may overhear the conversation.

Telehealth is not appropriate for psychiatric emergencies. If you are experiencing a mental health crisis, please:

• Call 988 (Suicide & Crisis Lifeline)
• Call 911 or go to your nearest emergency room
• Contact the Crisis Text Line by texting HOME to 741741

At the start of treatment, you will be asked to provide a local emergency contact and your physical address so that emergency services can be contacted if necessary during a session.

Anne Rose is licensed as a Marriage and Family Therapist (LMFT #97472) in the State of California. Telehealth services are provided only to clients who are physically located in California at the time of each session. It is your responsibility to ensure you are within California during all sessions.

Sessions will not be recorded without the explicit written consent of all parties. Any request to record a session must be discussed and agreed upon in advance.

• You have the right to withdraw consent for telehealth services at any time without penalty
• You have the right to request in-person services if clinically appropriate and available
• You have the right to ask questions about telehealth at any time
• All HIPAA privacy rights apply equally to telehealth services

By scheduling and participating in telehealth sessions with Anne Rose, LMFT, you acknowledge that you have read, understood, and agree to the terms of this Informed Consent for Telehealth Services.

If you have questions about this consent, please contact Anne before your first session.