Forms and Telehealth Information
To download and complete:
Adult Intake Form
If needed, Release of Information
Release of Information
To review:
Notice of Privacy Practice
Use of Email in Communication With My Provider
Your Patient Portal
Once you have received information about your patient portal access (username and initial password), you will be ready to use the patient portal for
- secure messaging about non-urgent concerns
- review the specifics of you appointment time from the weekend prior to your appointment
- established clients can use the Login button below. For your convenience another Login is on the Welcome page.
Telemedicine Services
Telemedicine is not appropriate in all situations and I will first determine, whether your concerns can safely and effectively be addressed with Telehealth. I use an online videoconferencing platform that complies with the US health care security and confidentiality standards (HIPAA).
You need a PC or tablet (NOT a smart phone), a Google Chrome, or Firefox browser, best updated. You just paste the link to my online waiting room in the browser. It is always the same. You will need to allow that the software uses your camera and microphone, and then sign in at the time of your appointment. If there are technical difficulties on either side, we will connect with an agreed upon back-up mode. I will always need to know from you, where you are, and how I can reach you in case we get disconnected.
I need you to review and sign the Tele-mental-health Informed Consent Form. Please ask me any questions you may have.
To download and complete:
Adult Intake Form
If needed, Release of Information
Release of Information
To review:
Notice of Privacy Practice
Use of Email in Communication With My Provider
Your Patient Portal
Once you have received information about your patient portal access (username and initial password), you will be ready to use the patient portal for
- secure messaging about non-urgent concerns
- review the specifics of you appointment time from the weekend prior to your appointment
- established clients can use the Login button below. For your convenience another Login is on the Welcome page.
Telemedicine Services
Telemedicine is not appropriate in all situations and I will first determine, whether your concerns can safely and effectively be addressed with Telehealth. I use an online videoconferencing platform that complies with the US health care security and confidentiality standards (HIPAA).
You need a PC or tablet (NOT a smart phone), a Google Chrome, or Firefox browser, best updated. You just paste the link to my online waiting room in the browser. It is always the same. You will need to allow that the software uses your camera and microphone, and then sign in at the time of your appointment. If there are technical difficulties on either side, we will connect with an agreed upon back-up mode. I will always need to know from you, where you are, and how I can reach you in case we get disconnected.
I need you to review and sign the Tele-mental-health Informed Consent Form. Please ask me any questions you may have.
Frauke C. Schaefer, MD;
Tel (919) 357-7204; [email protected]