I understand that my psychiatric provider and clinic may communicate with me electronically regarding my care.

I authorize the clinic to communicate with me by Email, Text Message (SMS), and Patient Portal. Electronic communications may include the following.

• Appointment reminders.
• Scheduling or rescheduling appointments.
• Medication refill notifications.
• General treatment recommendations.
• Requests for follow-up.
• Billing or administrative information.
• Limited health information necessary for my care.

I understand that:

• Email and text messaging are not always secure methods of communication.
• Although the clinic takes reasonable precautions to protect my privacy, electronic communications may carry some risk of unauthorized access.
• I should not use email or text messaging for medical emergencies or urgent psychiatric concerns.
• If I am experiencing thoughts of harming myself or others or another emergency, I should call 911 or go to the nearest emergency department.

To improve efficiency and allow my provider to focus more attention on my care, I understand that the clinic may use secure, HIPAA-compliant artificial intelligence (AI) technology during my visit to assist with clinical documentation.

I understand that:

• AI technology may be used to assist in generating clinical notes from information discussed during my appointment.
• My treating clinician reviews, edits, and approves every clinical note before it becomes part of my medical record.
• AI technology does not make medical decisions or replace my clinician's professional judgment.
• My provider remains solely responsible for all diagnoses, treatment recommendations, prescriptions, and medical decision-making.
• Any AI technology used by the clinic is intended to comply with applicable privacy and security regulations, including HIPAA.