Opt-in Authorization and Informed Consent

 

In our ongoing effort to promote the health and wellbeing of our patients, our clinic offers all patients the opportunity to utilize the resources of the Lifespan web platform.

Lifespan platform screens patients for a variety of behavioral health conditions and social determinants of health factors. Behavioral health conditions include things such as sleep problems, anxiety, depression, substance use, and more. Social determinants of health factors include such things as housing, food and income insecurity. Behavioral health conditions and social determinants of health factors, if left untreated, often contribute to poor health. So, identifying these conditions, and getting them addressed is essential to overall health and wellbeing.

By creating your account on the Lifespan platform, you hereby understand and agree that you will periodically be prompted to complete screening surveys that let us know the status of your behavioral health. Individual surveys typically take about 5 minutes to complete. However, if you screen “at risk” for any behavioral health conditions, you may be prompted to complete a more thorough screening.

You will have the option to complete screenings on your own (known as a “self-administered” screening), or with the assistance of a clinic staff member (known as a “facilitated” screening).

Self-administered screenings may be completed using a tablet computer provided to you by our staff in our waiting room, or, alternatively, can be completed on your own time from the privacy of your home or office.

If you elect to complete screenings remotely in the privacy of your home or office, you must have internet connectivity and an internet connected device (computer, tablet, or smart phone) with which to complete such remote screenings.

Screening prompts for such remote screenings may be sent to you via email, text message and/or voice message reminder. Please inform out staff as to which prompting method(s) you prefer.

Note: You may receive prompts up to 6 times for each prompting method, until you have completed the requested screening. Also, be advised that if you elect to have prompts sent via text message, normal text messaging rates charged by your cellular carrier will apply.

The Lifespan platform is an extremely valuable resource that will help you improve and maintain the quality of your health and wellbeing. Accordingly, we urge all of our patients to take advantage of this very valuable service!

Please note: Your participation in this service is completely voluntary. You are not required to participate in this service as a condition of receiving medical services from our facility.

Informed Consent

 

By creating your account on the platform, and by completing requested or prompted screenings, you hereby consent to have your screening results automatically forwarded to our response team. Our response team consists of a variety of medical professionals and support staff employed by, or affiliated with, our facility.

In addition, if your screening responses indicate that you are “at risk” for any behavioral health conditions, you are hereby advised and consent to the following:

• A response team member will attempt contact you to provide additional support, as needed.
• Contact may be initiated by phone, text message, and/or via email.
• Emails, text messages, and voice messages, as applicable, will be sent to you from thrive@LifespanPlatform.com, bearing the name of our facility. These communications will contain links to the platform log-in page and/or to the screening surveys themselves, along with reminders and instructions for completing the pending surveys. To ensure your privacy relative to these communications, you are hereby advised:
  • To avoid using public, or shared devices, shared email, cell phone and voice mail accounts;
  • To safeguard these accounts and account passwords at all times; and
  • To not leave devices unattended when logged into the platform to avoid these communications being accessed by unintended third parties.

 

By creating my account on the platform, I hereby attest that I have thoroughly reviewed, understand, and consent to the foregoing.