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Teletherapy Consent

Teletherapy Consent

As you are aware, the Clinic has suspended in-person sessions in the current public health crisis related to the novel coronavirus, COVID-19. To minimize disruptions to care we will be offering telepsychology services via a secure HIPAA-compliant electronic videoconferencing system on an interim basis. Procedures to safeguard your Protected Health Information, PHI, are already in place at our Clinic and will be extended to these videoconference communications. These communications incorporate network and software security protocols to protect your confidentiality.

You may choose secure videoconferencing for interim sessions if you, your therapist, and your therapist’s supervisor agree that this is appropriate so that your sessions can continue. At our UNC-Chapel Hill Clinic, we use a secure version of Zoom as our videoconferencing platform.

Please carefully review the following information and discuss any questions that you have with your therapist before agreeing to participate in telehealth videoconference sessions:

Below are potential benefits, for example, continuing treatment, and risks of telepsychology, for example, potential unanticipated limits to patient confidentiality, that may differ from in-person sessions.

You are agreeing to use secure, HIPAA compliant, Zoom which has been selected for our clinic’s interim telepsychology sessions. Your therapist will provide information for you on how join to a secure Zoom meeting for your telepsychology sessions.

You will need to use a password protected cell phone, tablet, laptop or PC with video capability for the telepsychology sessions.

You will need to ensure that you use a secure internet connection rather than public/free Wi-Fi.

Headphones will make it easier to hear your therapist and will add additional security.

It is important to be on time. We ask that you join the scheduled videoconference meeting a few minutes before the scheduled time to minimize delays. If you need to cancel or change your telepsychology appointment, you must notify your therapist in advance by phone or email.

We will use your mobile phone as the back-up plan. Therefore, we will need to confirm a number where your therapist can reach you 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, this may be an update from the information from the initial intake information, and the closest emergency department or service to your location if you experience a crisis.

If you are not an adult, 18 years old or older, we will need the permission of your parent or legal guardian, and their contact information, for you to participate in telepsychology sessions.

We will charge you for remote telepsychology sessions at your regular rate. These sessions may not be reimbursable if you request an invoice and submit the invoice to your insurance company.

Please use the following mailing address for payment by personal check, cashier check, or money order. Shortly, we will also accept credit card payments.

  • UNC, Department of Psychology and Neuroscience
  • ATTN: Carolle Epstein, Clinic Manager
  • Campus Box 3270, 235 East Cameron Avenue
  • Chapel Hill, NC 27599-3270

Your agreement to the information above and your participation in secure Zoom sessions indicate that you understand the benefits of continuing treatment and the additional potential risks of remote telepsychology sessions.

Thank you! We hope to respond to your inquiry within a couple of business days. At the start of the academic semester, August/September and January/February, we receive a large amount of inquiries and may be slow to respond.

If you have not received a response within a couple of business days, please leave a message on the clinic voicemail, 919-962-6906, or you email us at clinic@unc.edu