Video Visit Services Informed Consent and Patient Acknowledgement of Terms and Conditions

Welcome to Inova's MyChart Video Visit Services ("Video Services"), an online, real-time health care practitioner consultation service.

Video Services are not for use for medical emergencies or urgent situations. In the event of a medical emergency, please call 911 immediately.

Use of Video Services is conditioned upon your acceptance of these terms and conditions. By proceeding with Video Services, you are indicating that you have carefully reviewed and agree to these terms and conditions. If you do not agree to these terms and conditions, you may choose to schedule an appointment for an in-person visit at your preferred Inova facility.

Please be advised that the laws of the state where the patient is physically located at the time of the virtual visit will apply. Inova providers are licensed in Virginia and may not be licensed or otherwise meet a professional licensure exception to provide Video Services to patients physically located outside of Virginia during the appointment. By going forward with Video Services, you expressly acknowledge and attest that you desire to receive Video Services from an Inova provider who is licensed in Virginia. You also understand and agree that any dispute, including personal injury claims, related to Video Services will be subject to the exclusive jurisdiction of Virginia courts and governed by Virginia law.

Video Visit Terms and Conditions

Description of Video Services

Video Services involve a health care practitioner who is at a site remote from your location at the time of the visit, and may require the transmission of video, audio, images, or other types of electronic data about you and your health condition.
Your remote health care provider will determine whether the condition being diagnosed or treated is appropriate for Video Services. Activities permitted using Video Services include: consultation, diagnosis, treatment, prescriptions and patient education. Video Services do not guarantee that the nature of your problem is suitable for remote care or that care will achieve any specific effect.
Inova considers Video Services to be private, and your remote practitioner will be in a private area during the visit. Similarly, you should be in a private location that does not allow others to see or hear you or the Video Services.
Potential benefits of using Video Services include high quality, efficient access to health care from the convenience of your remote location.

Potential limitations and risks of using Video Services include but are not limited to:

Inova does not guarantee that narcotic prescriptions will be provided as part of Video Services. If provided, narcotic prescriptions will be based on an Inova practitioner's professional clinical judgment and applicable federal and state law. Please be advised that before being able to lawfully prescribe narcotics to a patient for the first time through Video Services, an Inova practitioner is generally required to establish a true patient-practitioner relationship and conduct an in-person medical examination (with very limited exceptions).
Depending on your complaint or condition, it may be necessary for the health care practitioner to record a still image of you or of the Video Services during your session. By accepting these terms and conditions, you agree to such recording if deemed clinically necessary by your practitioner.
Not all insurance plans cover the cost of Video Services. Inova will bill any outstanding balance due and you will be responsible for the remaining balance to the extent permitted by law.

Representations and Warranties

You confirm the following are true when using and accessing Video Services:

You consent for your treating practitioners to exchange information with other remote health care practitioners to facilitate the provision of Video Services to the extent permitted by law.
If any of the previous statements become untrue, you will immediately notify Inova, and Inova may immediately suspend or terminate your access to Video Services.

Technology Requirements

Video Services can be accessed through a desktop or laptop computer with a webcam, microphone, and speaker when used with a compatible internet browser and service.
Video Services can be accessed on an Android or Apple mobile device or tablet via Inova MyChart app.
Standard internet data rates may apply and are the responsibility of the individual user. Please contact your internet service and/or mobile device provider to determine applicable rates.
Inova makes no warranty that videos service will meet your requirements, or that the session will be uninterrupted, timely, 100% secure, or error free. Inova is not responsible for transmission errors or corruption or compromise of data carried over local cellular or interchange telecommunication carriers.

Security and Termination of Access

You agree to prohibit anyone else from using your account and credentials and to immediately notify Inova of any actual or suspected unauthorized use of your account or credentials or other security concerns of which you become aware. In order to determine your compliance with these terms and conditions of use, Inova reserves the right, but does not assume the obligation, to monitor your access to and use of Video Services. Inova may suspend, deny or terminate access to Video Services at any time for reasons that include but are not limited to: (i) suspected or actual violation of the terms and conditions of use; (ii) privacy and/or security concerns, including but not limited to a suspected or actual compromise of your account with Video Services; (iii) protection of intellectual property; and/or (iv) safety, security, welfare, and/or reputation of Inova or its patients, customers, staff, facilities and programs. If Inova suspends, denies, or ends your access to Video Services, you may still choose to seek care in-person at your preferred Inova facility.

MyChart is a registered trademark of Epic Systems Corporation.