Effective date: February 1, 2026

This consent describes how telehealth works at Inspire Mind & Body and what you should know before your first telehealth visit with Nina Ali, PMHNP-BC, FNP-BC.

1. What telehealth is

Telehealth is the delivery of psychiatric evaluation, medication management, or psychotherapy using secure, real-time video (and, where appropriate, audio) technology. Your clinician and you will be in different physical locations during the visit.

2. What to expect

• Visits take place on a HIPAA-compliant video platform covered by a Business Associate Agreement.
• You will receive a secure link to join each session. Please join from a private, quiet location where you can speak freely.
• You must be physically located in the State of Texas during any clinical telehealth visit. We will confirm your location at the start of each visit; if you are outside Texas, the visit cannot proceed.
• You must be at least 18 years old, or, if you are a minor, a parent or legal guardian must provide consent and be available during visits as clinically indicated.

3. Benefits

• Greater access to care, particularly for patients in Richmond, Stafford, Rosenberg, or other parts of the greater Houston area
• Reduced travel, wait time, and exposure to illness
• Comparable clinical quality to in-person visits for most outpatient psychiatric and psychotherapy services

4. Limitations and risks

• Technology can fail. Audio or video may drop, lag, or disconnect.
• Some clinical situations are not appropriate for telehealth and may require an in-person visit or a higher level of care (e.g., active suicidal intent, acute psychosis, severe eating disorder requiring medical monitoring).
• Certain physical examinations or laboratory monitoring cannot be performed remotely.
• Controlled-substance prescribing follows federal and Texas law and may require in-person evaluation at specified intervals.
• Privacy depends in part on your location during the visit. Please use a private setting.

5. If the connection drops

If the video connection fails and cannot be re-established within a few minutes, your clinician will call you at the phone number on file to complete the visit by phone or reschedule.

6. Emergencies

Telehealth is not for emergencies. If you are in crisis:

• Call or text 988 — the Suicide and Crisis Lifeline
• Call 911 for life-threatening emergencies
• Go to the nearest emergency room

At the start of each telehealth visit, your clinician will confirm your current physical address and the name and phone number of an emergency contact. If an emergency arises during a visit, your clinician will remain on the line with you and use a separate phone or channel to contact 911 or your emergency contact as appropriate. Your visit location is documented in the visit note each session.

7. Privacy and records

• Telehealth visits are treated the same as in-person visits in your medical record. They are documented and stored in our HIPAA-compliant system.
• Session recording. To support clinical documentation, continuity of care, and quality review, your clinician may record telehealth sessions by default. Recordings are stored in our HIPAA-compliant system under the same protections as the rest of your medical record; they are not shared outside the treatment team except as permitted or required by law (see our Notice of Privacy Practices). You have the right to opt out of session recording at any time — simply tell your clinician at the start of the visit or send a written request (email to [email protected] is acceptable). Opting out applies to future visits and will not affect your care.
• Patient recording. You may not record a session (audio, video, or screen capture) without the advance written consent of your clinician. Texas is a one-party-consent state for recordings in general; clinical telehealth visits require the clinician’s written consent because of the confidential and therapeutic nature of the relationship.
• Our Notice of Privacy Practices describes how your health information is protected.

8. Cost and insurance

Telehealth visits are billed in the same way as in-person visits. Coverage depends on your insurance plan; please verify telehealth coverage with your insurer before your visit.

9. Your rights

• You may decline telehealth and request an in-person visit at any time (subject to availability).
• You may withdraw this consent at any time by notifying Nina in writing (email to [email protected] is acceptable). Withdrawal applies to future visits.
• Declining telehealth will not affect your ability to receive care through other available modalities.

10. Consent

By scheduling a telehealth visit with Inspire Mind & Body, and by proceeding with a visit after reviewing this consent, you acknowledge that:

• You have read and understand this consent.
• You have had the opportunity to ask questions.
• You consent to receive care by telehealth under the terms above.

For the e-sign version in the patient portal, a signature line and date field follow the acknowledgment.