Telehealth informed consent in Puerto Rico

Telehealth is medical care at a distance. With us, every visit is a real-time video visit between you and Dr. Diana Nieves Castro, MD, a general practice physician licensed in Puerto Rico. We see adults and children of all ages. We send you a secure video link; it works on your phone, tablet or computer. We do not provide form-only, message-only or phone-call care.

The doctor evaluates, diagnoses and treats; if needed, she gives you a lab order for a lab near you. If appropriate, the doctor prescribes and we send your prescription to your pharmacy. We do not prescribe controlled substances. The doctor keeps a record of every visit, as she would for an in-person visit. See how it works.

Telehealth lets you see a doctor without traveling, from anywhere in Puerto Rico.

By video the doctor cannot examine you physically. So if your case needs it, she will give you a lab order, recommend an in-person visit or tell you to go to the ER, and explain why. A video visit does not guarantee a diagnosis, a prescription, a document or any particular result.

You choose the visit type when you request it (see pricing). If, in a follow-up or forms visit, the doctor finds you need a full doctor visit, she explains why, and only with your consent do you pay the difference. We never charge the difference without your consent.

No technology is completely secure. Although we use a HIPAA-compliant electronic health record provider and protect your information, there can be technical failures, dropped connections or unauthorized access. You can help too: have the visit in a private place, on a device you control and on a network you trust.

Your record and video visit are held by a provider that commits to protecting your health information. Visits are not recorded, in video or audio, and we ask that you do not record them either. The ID shown on camera is checked by sight only: no photos or screenshots are taken. Details in the privacy notice.

You can refuse care by telehealth, or withdraw your consent at any time, without losing your right to receive care in other ways. If you do not sign, or you withdraw your consent before the doctor starts to evaluate you, we refund you in full. See cancellations and refunds.

We see children of all ages. In Puerto Rico the age of majority is 21, and the medical board's telemedicine regulation (Reglamento 9107, Regla 19) requires written authorization from whoever holds patria potestad (parental authority) or from a court-appointed guardian. This applies to every visit type. If the patient is under 21:

With a teenager, the doctor may talk with the patient alone for part of the visit, only if the parent or guardian agrees. The doctor keeps that conversation private during the visit, but she notes in the record what matters for the patient's health, and the parent or guardian can ask for the record. The doctor must also act if there is a risk that the patient will harm themselves or others, and if she suspects abuse.

Health professionals in Puerto Rico are required by law to report any suspected abuse or neglect of a child under 18 to the authorities (Ley 57-2023). By signing, you acknowledge that the doctor will meet that duty.

The doctor is licensed in Puerto Rico, so the patient must be physically in Puerto Rico for the whole visit. Visitors to the island are welcome. At the start, the doctor will ask for the exact address where you are, so help can be sent if there is an emergency during the visit. If you are not in Puerto Rico, the visit does not go ahead and we refund you.

This service is not for emergencies. If you have an emergency, call 911 or go to the nearest emergency room. If the doctor spots an emergency during the visit, she will tell you to call 911 or, if needed, get help sent to the address you gave. See when to go to the ER.

You sign this consent online, on our page to sign the informed consent, before your first visit. We send you the link after you request a visit, and you can sign on your phone, tablet or computer. The law allows this consent to be electronic (Ley 68-2020). When you sign, you download your PDF copy. If you prefer to sign on paper, email us and we will explain how. You can ask for a copy of what you signed at any time by writing to [email protected].