Telehealth informed consent
Effective: 2026-09-30 · Version 1.0
Before your first visit you sign a written telehealth informed consent, as Puerto Rico's Ley 168-2018 requires. It explains how care is delivered, its benefits and limits, the confidentiality risks of the technology, and your right to refuse. If the patient is under 21, a parent with patria potestad (parental authority) or a legal guardian signs it.
What telehealth is and how we deliver care
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 doctor licensed in Puerto Rico, through SimplePractice. We do not provide form-only, message-only or phone-call care. The doctor keeps a record of every visit, as she would for an in-person visit.
Benefits and limits
Telehealth lets you see a doctor without traveling, from anywhere in Puerto Rico.
It has limits: the doctor cannot touch you, listen to your chest, look in your ears with an otoscope or do in-person tests. So she may decide that you need an in-person exam or test, or emergency care, and she will tell you. A video visit does not guarantee a diagnosis, a prescription or any particular result.
Confidentiality risks of the technology
No technology is completely secure. Although we use a health platform 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.
How we protect your data
Your record and the video visit are in SimplePractice, which 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 you show on camera is checked by sight only: no photos or screenshots are taken. Details in the privacy notice.
Your right to refuse
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 withdraw consent before the visit, we refund you. See cancellations and refunds.
Patients under 21: patria potestad and guardian presence
In Puerto Rico the age of majority is 21, and the telehealth regulation requires written authorization from whoever holds patria potestad (parental authority) or from a court-appointed guardian. We see children from 6 months old. If the patient is under 21:
- A parent with patria potestad, or a legal guardian, signs this consent before the visit and states their relationship to the patient.
- A legal guardian must have the court order appointing them.
- That person stays on camera for the whole visit.
- At the start they show official photo ID on camera, and the doctor confirms the patient's name and date of birth.
- For now we do not accept other adults in their place, such as grandparents, aunts, uncles or caregivers, even with an authorization.
- If the authorized person is not there or their identity can't be verified, the visit does not go ahead and we refund you in full.
Teenagers and the limits of confidentiality
With a teenager, the doctor may talk with the patient alone for part of the visit, only if the parent or guardian agrees. What is said then is confidential, with limits: the doctor must act if there is a risk that the patient will harm themselves or others, and if she suspects abuse.
Mandatory reporting of 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.
You must be physically in Puerto Rico
The doctor is licensed in Puerto Rico, so the patient must be physically in Puerto Rico for the whole visit. 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.
Emergencies
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.
Where and when you sign
After you request a visit, you receive a SimplePractice invitation. There you read and sign this consent, in writing, before your first visit. You can ask for a copy of what you signed at any time by writing to [email protected].
Frequently asked questions
- Do I have to sign an informed consent?
- Yes, in writing, before your first visit. You sign it in SimplePractice after you request a visit. If the patient is under 21, a parent with patria potestad or a legal guardian signs it.
- Can the visit be recorded?
- No. Visits are not recorded, in video or audio, and we ask that you do not record them either.
Sources
- Puerto Rico Telemedicine and Telehealth Act, Ley 168-2018, Art. 10 (LexJuris, Spanish) (accessed 2026-09-30)
- Telehealth regulation, Reglamento 9518 (Puerto Rico Department of Health, Spanish) (accessed 2026-09-30)
- Ley 139-2019 on consent for the treatment of minors (OGP, Spanish) (accessed 2026-09-30)
- Ley 57-2023, child abuse prevention and protection act (LexJuris, Spanish) (accessed 2026-09-30)