Telemental Health Informed Consent
Please note that due to "Governor Eric J. Holcomb recent announcement to protect and support Hoosiers during the COVID-19 outbreak; telehealth services for mental health, substance use disorder and prescribing for Medicaid covered services will be expanded. Mental health professionals are permitted to practice via telemedicine." Tides of Life will be temporarily providing telemedicine therapy using technology including but not limited to phone, computer and audio/visual equipment.
The priority is to provide services as quickly as possible to assist clients in maintaining their mental health during this time. Please note, that all efforts are being made to provide services in a confidential manner, but it is not practical to implement all HIPPA regulations at this time as acknowledged and authorized by the Governors order. In addition, the use of technology introduces the risk of data breaches and equipment failure that are beyond the control of Tides of Life and its providers. Telemedicine services will be temporarily provided until the ability to see clients in the office is permitted.
Tides of Life in no way implies that your insurance company or EAP provider will cover services provided via Telemedicine. It is the client's responsibility to contact the company and determine the coverage for this service.
With this in mind, please review and complete the form below to allow Tides of Life to provide services via Telemedicine.