1. I hereby authorize KSHEMAVANA SDM INSTITUTE OF NATUROPATHY AND YOGIC SCIENCES to use the telehealth practice platform for telecommunication for evaluating, testing and diagnosing my medical condition.

2. I accept that the professionals can contact interactive sessions with video call; however, I am informed that the sessions can be conducted via regular voice communication if the technical requirements such as internet speed cannot be met.

3. I understand that technical difficulties may occur before or during the telehealth sessions.

4. I agree that my medical records on telehealth can be kept for further evaluation, analysis and documentation, and in all of these, my information will be kept private.