Consent Forms

As You Are Consent Forms

In order for As You Are to provide telehealth services for your family, we’re required to have a number of consents on file. Below, are the individual consents that you will be asked to acknowledge when you schedule an appointment. If you would like a copy of your signed consent, please reach out to the support team at

HIPAA Notice of Privacy Practices

Informed Consent for Telehealth Services

Assignment of Benefits and Designation of Authorized Representative

Informed Consent for Electronic Communication

Financial Policy

Card on File Agreement

Virtual Care Registry Consent Form

Virtual Care Study Consent Form

Release of Information