Tele-Health Services and Consent

This informed consent addendum covers counseling / psychotherapy sessions with Paul Fitzgerald, PsyD, via a tele-health platform using real-time video and audio communication. This will be done using the Psychology Today "Sessions" platform or the SimplePractice platform, both of which are secure, HIPAA-compliant, and private. A link address will be generated for each session, and will be e-mailed to the client.

There are potential benefits and risks of video-conferencing. The benefits include being able to meet when circumstances prevent in-person sessions. The limitations may include limits to patient confidentiality (due to sessions being conducted where others may overhear the client on their end) and other factors that differ from in-person sessions. These may include:
* Difficulty engaging in some interactions and procedures (including psychological testing and EMDR).
* Difficulties due to bandwidth and Internet carrier variations, which can lead to disconnection, sound problems, blurred or frozen video,, or time lags in transmission.

By giving consent, you understand that if you wish to discontinue tele-health visits, you can request to do so. However, until the COVID-19 pandemic subsides, Dr. Fitzgerald may not be able to offer in-person sessions.

Confidentiality still applies for telepsychology services, and nobody will record the session without the permission from the other person(s).

You are agreeing to use the video-conferencing platform selected for our virtual sessions, and the psychologist will explain how to use it. As your psychologist, Dr. Fitzgerald will always use a secure and HIPAA-compliant platform unless circumstances make that impossible. If that happens, you have the choice of rescheduling the session or using a less-secure but still private platform such as FaceTime. This will only be a last-resort choice during the COVID-19 pandemic.

You will need to use a webcam, tablet, or smartphone during the session. Additionally, it is important to be in a quiet, private space that is free of distractions (including cell phone or other devices) during the session.

To help ensure confidentiality, it is important to use a secure internet connection rather than public/free Wi-Fi.

It is important to be on time. If you need to cancel or change your tele-appointment, you must notify the psychologist in advance by phone or email. We also need a back-up plan (e.g., phone number where you can be reached) to restart the session or to reschedule it, in the event of technical problems.

We need a safety plan that includes at least one emergency contact and the closest emergency room to your location, in the event of a crisis situation.

If you are not an adult, we need the permission of your parent or legal guardian (and their contact information) for you to participate in tele-health sessions.

Although Dr. Fitzgerald will make every effort to confirm eligibility and benefits for tele-health sessions, you should confirm with your insurance company that the video sessions will be reimbursed; if they are not reimbursed, you are responsible for full payment.

As your psychologist, I may determine that due to certain circumstances, tele-health is no longer appropriate and that we should resume our sessions when it becomes possible to do so in person.

You understand that the provider of the tele-health platform (Simple Practice or Psychololgy Today) does not provide healthcare services but is simply a communications services provider. You agree that you will be responsible for maintaining privacy on your end of the communication by finding a private location for sessions and not sharing the session link with anyone else. You agree that the link may be sent by e-mail, even though it is understood that not all e-mail can be guaranteed to be impervious to hacking or other potential privacy issues.