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AHRQ Sample Telehealth Consent Form

Wednesday, May 6, 2020


Many agencies have likely put their telehealth programs in place, given COVID-19. AHRQ has a sample Easy-to-Understand Telehealth Consent Form that might be of some value to programs looking for patient materials. The form is written in a question-answer format covering, for example, an explanation of telehealth and privacy issues. The form is a Word document and thus easily modified by agencies looking to adapt and adopt it for their operations. The form is one of the resource in AHRQ's Health Literacy collection., a federal website was prepared by HRSA, has resources for both patients and providers.


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