Iridia Health Hub
Consent to Virtual Care and Nurse Practitioner Services
Rapid Medical Consult (NP) – Iridia Health Hub
Duration: 30 minutes | Virtual
Fee: $135
Contact: 604-685-4747 ext. 433
Email: booking@iridiamedical.com
Purpose of This Form
This consent form ensures that you understand the scope, limitations, and risks associated with accessing virtual healthcare services through the Rapid Medical Consult (NP) program provided by Iridia Health Hub. Please read carefully and acknowledge each section.
Nature of the Service
You will be receiving medical consultation from a licensed Nurse Practitioner (NP) via a secure virtual platform. Services may include:
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Medical notes for short-term work absences
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Referrals to allied health specialists (e.g., physiotherapy, counselling)
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Assessment of general or unexplained health concerns
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Guidance on when in-person or further medical care is needed
Service Inclusions
Prescription Refills
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Chronic conditions: diabetes, hypertension, anxiety, hypothyroidism, eczema, depression, etc.
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Select acute conditions: UTIs, sinus/respiratory infections, STIs, acne, allergies
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Exclusions: Controlled substances (narcotics, benzodiazepines, sedatives, stimulants)
Medical Notes & Specialist Referrals
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Sick notes for work (under one week)
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Medical leave forms (subject to review)
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Referrals to counselling, kinesiology, dermatology, podiatry, physiotherapy, massage therapy
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Exclusions: Disability forms, ICBC/WCB claims
General Health Concerns
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Fatigue, headaches, nausea, minor injuries, rashes, skin infections
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Mental health concerns: stress, anxiety, sleep disturbances
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Women’s and men’s health: menstrual issues, menopause, prostate, UTIs, STIs
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Preventative health and wellness counseling
Limitations of the Service
Please acknowledge that this virtual service has specific boundaries:
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Virtual appointments restrict the scope and depth of a full physical examination. You may be directed for in-person assessment or ordered diagnostics test to evaluate your concerns
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No prescriptions will be provided for controlled substances
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No disability forms or documentation related to ICBC/WCB claims will be completed
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Not appropriate for medical emergencies – if you are experiencing chest pain, difficulty breathing, severe pain, or other serious symptoms, please call 911 or visit the nearest emergency department
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Your NP may recommend in-person care or additional testing if needed
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The service is not a substitute for regular primary care or specialist follow-up
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Not all requests will be fulfilled at the discretion of the NP based on clinical appropriateness
Technology Risks
While we use secure, encrypted platforms, there are inherent risks to using virtual platforms, including:
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Technical failures or disconnection
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Possible unauthorized access to personal information despite best efforts to maintain privacy
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Potential limits in assessment accuracy due to the virtual nature of the consultation
Confidentiality
Your health information will be kept confidential in accordance with provincial and federal privacy laws (e.g., PIPA in BC). Your data may be stored securely in electronic health records systems and may be shared with other healthcare providers involved in your care if necessary and appropriate.
Acknowledgment and Consent
Please read each statement to confirm your understanding:
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I understand the scope and limitations of the Rapid Medical Consult (NP) service.
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I understand that this is not an emergency or crisis care service.
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I understand that controlled substance prescriptions are excluded
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I understand that disability forms, and WCB/ICBC-related services may not be appropriate for virtual consultations and therefore may not be completed.
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I understand that I may be referred to in-person care or further investigation if deemed necessary by the NP.
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I consent to receiving care through virtual platforms and accept the associated risks.
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I understand my personal health information will be handled in accordance with applicable privacy laws.
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I understand that cancellations or rescheduling must be made at least 72 hours prior to my scheduled session and that any cancellations or rescheduling within 72 hours of the scheduled session will incur a fee of 50% of the appointment cost. Cancellations within 24 hours prior to the scheduled session will incur a fee of the whole appointment cost.
Should you have any questions or concerns prior to booking this session, please feel free to email us at booking@iridiamedical.com or phone us at 604-685-4747 ext. 433.