Telehealth Informed Consent
Before receiving care through Cyti Psychological's telehealth platform, please review what telehealth involves. By scheduling and attending telehealth sessions, you acknowledge and agree to the following:
- Telehealth means receiving behavioral health services remotely using secure, HIPAA-compliant audio and video technology.
- Telehealth has benefits (convenience, access) and limitations. In rare cases, technical failures may interrupt or delay care, and your clinician may determine telehealth is not appropriate for your needs and recommend in-person care or a referral.
- Telehealth is not appropriate for emergencies. If you are experiencing a medical or mental health emergency, call 911, or call or text 988 for the Suicide & Crisis Lifeline.
- You must be physically located in a state where Cyti operates and your clinician is licensed (currently California, Oregon, or Washington) at the time of each session, and you will tell your clinician your location at the start of each session.
- You are responsible for being in a private, safe location during sessions. Cyti uses encrypted technology to protect your information, but no technology is perfectly secure.
- Care for minors must be arranged and consented to by a parent or legal guardian.
- Your records are protected health information and are handled according to our Notice of Privacy Practices.
- You may withdraw consent to telehealth at any time without affecting your right to future care; talk with your clinician or our support team about alternatives.
- Insurance coverage for telehealth varies by plan and state; our team will help you verify coverage before care begins. Uninsured and cash-pay patients may request a Good Faith Estimate of expected charges.
This summary is provided for transparency and review by our compliance team; the final executed consent is completed during intake.