The purpose of this form is to obtain your informed consent to participate in virtual or telehealth physical therapy services provided by Resume Mobility Physical Therapy, LLC. Virtual or telehealth physical therapy involves the use of electronic communications to enable physical therapist(s) to provide care to patients remotely.

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Introduction: Virtual physical therapy, also known as telehealth or telemedicine physical therapy, involves the use of electronic communication technologies to deliver services remotely. This document serves to inform you of the nature, risks, benefits, responsibilities, and alternatives associated with virtual physical therapy.

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Services Provided: Virtual physical therapy services by Resume Mobility Physical Therapy, LLC may include, but are not limited to:
   • Evaluation and assessment of your condition
   • Development and implementation of a treatment plan
   • Instruction on exercises and activities
   • Educational resources
   • Monitoring of progress and adjustments to the treatment plan

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Nature of Virtual Physical Therapy
   • Virtual physical therapy involves the use of live video, audio, or other digital means to provide assessment, treatment, and guidance.
   • The services provided will follow the same standard of care as in-person physical therapy but may have limitations due to the virtual format.
   • The technology used is HIPAA-compliant, but there is always a risk of a data breach or unauthorized access.
   • Your personal health information will be kept confidential and protected under HIPAA regulations.
   • Sessions may be recorded for the training and quality purposes.

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Potential Benefits:
   • Increased access to care, especially for patients in remote or underserved areas.
   • Convenience and flexibility in scheduling and receiving treatment.
   • Continuity of care during times when in-person visits are not possible.

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Potential Risks:
   • Technology failures or interruptions may impact communication and the effectiveness of treatment.
   • The therapist’s ability to perform a hands-on assessment and treatment is limited.
   • A lack of direct supervision may increase the risk of improper exercise technique or injury.
   • The virtual nature of the session may not be appropriate for all conditions. If deemed necessary, in-person care may be recommended.

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Patient Responsibilities:
   • You must have access to a reliable internet connection; necessary equipment (e.g., computer, smartphone, webcam); and a private, safe space for therapy sessions.
   • You must provide accurate health information and update your therapist on any changes in your condition.
   • You are responsible for following the therapist’s instructions and reporting any issues or concerns.
   • You must be physically present in South Carolina during the virtual session unless otherwise permitted by law.

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Alternatives: If you do not wish to participate in virtual physical therapy, you may discuss alternative options with your physical therapist, such as in-person visits or other forms of care.

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By paying for your services, you (patient or patient's guardian in case of minor) acknowledge and agree that:
   • You have read and understood the contents of this Informed Consent for virtual physical therapy provided by Resume Mobility Physical Therapy, LLC.
   • You voluntarily agree to receive virtual physical therapy services.