Remote Patient Monitoring (RPM) Consent Form

I acknowledge that I am the sole user of the PAP equipment and will adhere to the provided instructions. I will use the device exclusively for my personal health program. I also understand that participation in this program is limited to one Medical Provider at a time.

The device collects usage data and transfers them to an online platform for the Remote Patient Monitoring (RPM) program. I understand that readings will be reviewed periodically by a Qualified Health Professional. This is not an emergency response device or a 24/7 monitoring service. In case of medical emergencies, I will call 911.  I consent to being contacted remotely via email, phone, video chat, or other approved methods. Regular check-in via phone or video call are mandatory for reviewing results, discussing progress, and addressing concerns. Failure to participate in monthly check-in will result in the termination of the service.  My Sleep Physician will have access to my PAP data. I also authorize RPS staff to share my data with my Sleep Physician or other healthcare professionals, as needed, to enhance my care. All data will be securely transmitted, stored, and reviewed at the clinician's discretion, forming part of my patient record.  I can withdraw from the program at any time by returning the device and completing a withdrawal form. RPS will securely store collected data in the cloud-based Sanusom database. I will aim to collect data daily or at least 16 times per month.