I understand that there may be times when it is clinically appropriate to have sessions via teletherapy. I hereby consent to engage in teletherapy with Karen M.Buckley. I understand that “teletherapy” includes consultation, treatment, transfer of medical data, emails, telephone conversations and education using interactive audio, video, or data communications. I understand that teletherapy also involves the communication of my medical/mental health information, both orally and visually.
I understand that I have the following rights with respect to teletherapy:
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Karen M. Buckley - 2608 Pacific Ave SE Suite C, Olympia, WA 98501 - Phone: (360) 556-0201 - Fax: (360) 357-6218
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