Telehealth Consent

While telehealth is widely used, you understand there are potential risks, including:

• Technology issues: Internet interruptions, poor audio or video quality, or equipment failure may delay or end a session.
• Limited assessment: Your provider may not be able to observe or assess you as fully as in an in-person visit.
• Privacy risks: Although we use secure systems, electronic communication always carries some risk of unauthorized access.
• Incomplete evaluation: If your provider decides telehealth is not appropriate, they may end the session and recommend an alternative form of care.
• Different outcomes: The result of your evaluation may differ from what you expected.

• Your evaluation will be conducted by a professional licensed in the state where you are physically located at the time of the session.
• You agree to provide your accurate location, and to inform us if you move or travel to another state before your evaluation.
• Services cannot be provided if you are outside the United States during your session.

• A stable internet connection
• A working device with a camera and microphone (if video is required)
• A private, quiet, and safe space for your session

We recommend not participating while driving, in public places, or on unsecured public Wi-Fi.

• Your information is handled in accordance with our privacy policy and HIPAA Compliance practices.
• Telehealth sessions are conducted over secure, encrypted technology.
• Sessions are not recorded by My ESA Therapist unless you are informed and give consent in advance.
• Confidentiality has legal limits. A provider may be required to disclose information to protect your safety or the safety of others, or when required by law.
• You agree not to record, screenshot, or share any part of your session without written permission from all participants.

My ESA Therapist is not an emergency service.

If you are experiencing a mental health crisis, thoughts of harming yourself or others, or any medical emergency:

• Call 911 (or your local emergency number) immediately, or
• Call or text 988 (Suicide & Crisis Lifeline) in the United States, or
• Go to your nearest emergency room

Do not rely on our platform for urgent or crisis care.

• Email
• Phone calls
• SMS or automated messages

These communications may relate to scheduling, evaluation updates, documents, or service support. Standard message and data rates may apply. You may opt out of non-essential messages at any time.

Fees for evaluations are displayed before you proceed. As noted on our website, we authorize your payment first and only charge it after your evaluation is completed. For more details, please review our refund policy.

• Ask questions about telehealth before and during your evaluation
• Decline or stop a telehealth session at any time
• Request an alternative, such as in-person care with a local provider
• Request access to your information, subject to applicable laws
• Withdraw your consent at any time by contacting us

Withdrawing consent may prevent you from continuing with our online services, and it does not affect services already completed.