
Telemedicine Forms
Informed Consent / Confidentiality
- Consent To Treatment And Release Of Information
c/o Kentucky Telecare, University of Kentucky Chandler Medical Center, Lexington, KY - Consent To Participate In A Telemedicine Consultation
c/o Marquette General Hospital Health System, Marquette, MI - Teledermatology Consult Request
c/o ATA Teledermatology Special Interest Group - Ophthalmology Consent Form
c/o ATA Teleocular Health Special Interest Group
Evaluations
- Telemedicine Consultant Evaluation Form
c/o Kentucky Telecare, University of Kentucky Chandler Medical Center, Lexington, KY - Telemedicine Originator Evaluation Form
c/o Kentucky Telecare, University of Kentucky Chandler Medical Center, Lexington, KY - Telemedicine Patient Evaluation Form
c/o Kentucky Telecare, University of Kentucky Chandler Medical Center, Lexington, KY
Other
- Store and Forward Teledermatology Template - Guidelines for Referring Physicians
c/o ATA Teledermatology Special Interest Group