Provider
Toolkit
The information to the right is a resource to consider for your telehealth practice. The providers of the material assume no responsibility for the information; these are only meant as guides when creating your own policies and procedures.
When using any of the materials, please add information specific to your practice to personalize the policies and procedures for your organization.
Wyoming Regulations
Interstate Compact
Example Forms
- Example MOU – Facility to Facility (CRMC Telepsychiatry)
- Example New Patient Packet (CRMC):
- Patient Registration Form
- Consent for Treatment
- Informed Consent for Telehealth Consultations
- Authorization to Release Health Care Information
- Authorization to Disclose Health Information
- Patient No Show Policy
- Medicare MSP Questionnaire
- Medical History Form
- Outpatient Ambulatory Screening
- Patient Health Questionnaire PHQ-9
- Example Telehealth Consent
Scheduling
American Telemedicine Association Guidelines
Veterans Toolkit
