Telepsychiatry Disclaimer Form

By proceeding with this booking, I consent to engage in telepsychiatry services provided by Dr. Cherishe Alleyne, MD, DM Psychiatry (Dr. Alleyne | Mind & Wellness).

I understand that:

Nature of Services

  • Telepsychiatry involves psychiatric care delivered through secure video conferencing.

  • It is similar to in-person care, but some aspects (e.g., physical examination) may be limited.

Confidentiality & Security

  • Sessions are conducted using secure platforms.

  • As with all online services, there is a small risk of technical failure or security breach.

  • All standard rules of confidentiality and privacy apply.

Limitations

  • Telepsychiatry may not be suitable for every condition.

  • Dr. Alleyne may recommend in-person visits if clinically necessary.

Patient Responsibilities

  • I will ensure I am in a private, safe space during sessions.

  • I will use a stable internet connection and a functioning device.

  • I will provide accurate, honest medical and personal information.

Emergencies

  • Telepsychiatry is not an emergency service.

  • If I am in crisis, actively suicidal, or unsafe:

§  In T&T: I will call 999 (police), 811 (ambulance), or Lifeline T&T (800-5588 / 866-5433 / 220-3636), or go to the nearest Emergency Department.

§  Outside T&T: I will call my local emergency number or go to the nearest Emergency Department.

Consent

By agreeing to these terms and conditions, I confirm that I understand the risks, benefits, and limitations of telepsychiatry and agree to participate.