Online Physiotherapy Consent Form

You can use this before online appointments.

Online Physiotherapy Consultation Consent

By booking an online consultation with Charlotte Davies Physiotherapy, you confirm that you understand and agree to the following:

Nature of Online Physiotherapy

Online physiotherapy consultations involve assessment, advice and rehabilitation guidance delivered via video consultation.

While many conditions can be assessed effectively online, remote consultations may have limitations compared to in-person examination.

Potential Limitations

Remote consultations may limit the physiotherapist’s ability to:

• Perform hands-on assessment

• Conduct certain physical tests

• Observe some aspects of movement or injury

If necessary, you may be advised to seek in-person physiotherapy or further medical assessment.

Patient Responsibilities

By participating in an online consultation you agree to:

• Provide accurate and complete health information

• Inform the physiotherapist of any worsening symptoms

• Follow exercise advice safely within your physical limits

Confidentiality

All consultations are confidential and handled in accordance with UK data protection regulations.

Clinical notes may be securely recorded as part of your healthcare record.

Emergency Situations

Online physiotherapy is not appropriate for medical emergencies.

If you experience severe symptoms such as:

• chest pain

• sudden neurological symptoms

• significant trauma

you should seek urgent medical care immediately.

Consent

By proceeding with an online consultation, you confirm that you:

• Understand the nature of online physiotherapy

• Have had the opportunity to ask questions

• Consent to receiving physiotherapy services remotely

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