(1) A practitioner-patient relationship may commence via telepractice following a practitioner's evaluation of the prospective patient to assess the patient's:
(a) need for services; and
(b) candidacy for telepractice, including behavioral, physical, and cognitive abilities to participate in telepractice services.
(2) Prior to initiating services, a speech-language pathologist or audiologist shall:
(a) make reasonable attempts to verify the identity of the patient;
(b) obtain alternative means of contacting the patient other than electronically;
(c) provide to the patient alternative means of contacting the licensee other than electronically;
(d) document whether the patient has the necessary knowledge and skills to benefit from the type of telepractice provided by the licensee;
(e) determine the availability of a facilitator, if needed, with the necessary level of training to assist at the patient's location;
(f) provide orientation and training to the patient in the use of telepractice equipment and the telepractice protocol at an appropriate level for the patient; and
(g) inform the patient in writing of the following:
(i) the limitations of using technology in the provision of telepractice;
(ii) the potential risks to the confidentiality of information due to technology used in telepractice;
(iii) the potential risks of disruption in the use of telepractice;
(iv) when and how the licensee will respond to routine electronic messages;
(v) in what circumstances the licensee will use alternative communications for emergency purposes;
(vi) who else may have access to patient communications with the licensee;
(vii) how communications can be directed to a specific licensee;
(viii) how the licensee stores electronic communications from the patient; and
(ix) that the licensee may elect to discontinue the provision of telepractice services.
(3) The written document required by (2)(g) shall be signed by both the licensee and the patient and maintained in the clinical record. If the patient is a minor, the document shall be signed by the patient's parent or guardian.