Effective Date: 02/20/2026

Telehealth involves the use of secure electronic communications and information technology to provide clinical services when the provider and patient are not in the same physical location. By engaging in telehealth services with Solidarity Mental Health, PLLC you acknowledge and agree to the following:

1. Nature of Telehealth Services

Telehealth may include:

• psychiatric evaluation and diagnosis

• medication management

• treatment planning and follow-up care

• patient education and care coordination

Services are delivered through secure, HIPAA-compliant platforms.

2. Potential Benefits

Telehealth allows:

• improved access to care

• increased convenience and flexibility

• reduced travel time and costs

• continuity of care

3. Potential Risks

As with any medical service, telehealth has potential risks, including:

• technical failures or interruptions

• reduced ability to respond to emergencies

• limitations in performing physical examinations

• potential, though rare, security risks despite safeguards

If technical issues occur, services may be rescheduled or continued by telephone when appropriate.

4. Confidentiality & Privacy

All telehealth services are provided using secure, HIPAA-compliant technology. Patient information is protected in accordance with federal and Washington State privacy laws.

Patients are responsible for:

• choosing a private location for sessions

• using secure internet connections when possible

• protecting the privacy of their own devices

5. Emergency & Safety Protocol

Telehealth is not appropriate for emergency situations.

If you are experiencing an emergency:

• Call 911, or

• go to the nearest emergency room.

At the start of sessions, you may be asked to confirm:

• your physical location

• a phone number for backup contact

• an emergency contact person

This information helps ensure safety if urgent intervention becomes necessary.

6. Technology Requirements

Patients are responsible for:

• having a functioning device with camera and audio

• reliable internet access

• a private setting suitable for confidential care

7. Prescribing & Controlled Substances

Medication prescribing via telehealth follows federal and Washington State regulations and clinical standards of care.

Controlled substances may be prescribed when clinically appropriate and legally permitted.

Additional identity verification or in-person evaluation may be required in certain circumstances.

8. Patient Rights

Patients have the right to:

• withdraw consent to telehealth at any time

• request in-person services when available

• ask questions about telehealth procedures

Withdrawal of consent will not affect the right to future care or treatment.

9. Consent to Telehealth Services

By signing practice intake documents or engaging in telehealth services, you acknowledge that you:

• understand the information above

• have had the opportunity to ask questions

• consent to receive services via telehealth