Patient Information

Consent Statement

I acknowledge that I have been informed about the nature, benefits, and potential risks of participating in virtual physical therapy sessions. I understand that:

Virtual sessions are conducted through electronic means and may involve limitations in assessment and intervention compared to in-person sessions.
All efforts will be made to maintain the confidentiality and security of my information as required by law.
I may withdraw my consent and discontinue participation at any time.
My therapist will discuss with me any alternative treatment options available.

Risks and Benefits

I have read and understand the information above, and I consent to receive physical therapy via virtual sessions.

Patient Signature

Date

Therapist Signature

Date

Informed Consent for Virtual Physical Therapy

Patient Information

Consent Statement

Risks and Benefits