TELEMEDICINE

Consent Form

If you wish to use telemedicine (i.e., telehealth via real-time, interactive audio and/or video), you must complete and turn in the below form. You may email, fax, or mail the forms. If emailing, a scanned signed document is preferred. But, if you do not have access to a scanner, you may take a picture of each page with your mobile phone and email the pictures to Dr. Moceri at dmoceri@behavioralchangeclinic.com. Please, do not submit any forms until instructed to do so by The Clinic or your Therapist.

• Telemental Health Services Consent Form

Virtual Waiting Room

After scheduling an appointment click on the hyperlink below to enter my virtual waiting room at Doxy.me. You will be prompted for a passcode, which will be given to you after your signed consent form is received and your telemedicine appointment is scheduled. After you receive your passcode, please test out your camera and microphone at any time by logging in and clicking on the "Pre-call Test" button in the lower left-hand corner well in advance of your appointment. Alternatively, you can test your device at any time without a passcode by going to their pre-test website. Doxy.me service only works with Chrome, Firefox, and Safari browsers (which can be downloaded for free on their respective websites). No additional software or downloads are needed. Doxy.me does not work with Microsoft Explorer or Edge.

• Dr. Moceri’s Doxy.me Waiting Room

Preparing for Your Telemedicine Session

Visit the “Telemedicine” section of the external links webpage for a useful preparation guide for maintaining confidential space with telehealth & telemedicine and maintaining an efficient internet connection.