Patient Communications | Consents

Patient Communications sends consents to patients to review and sign in the patient portal, either on a signature pad or in DocuSign. Consents can go to every new patient, to patients before a visit, or to one patient from their chart. A consent can also need a provider's countersignature after the patient signs. Signed consents are filed to the chart. This guide is part of Patient Communications.

Overview

• Admins set up consents on the Consents tab of Notifications Admin: which DocuSign template each consent uses, which consents every new patient gets, and which need a provider countersignature.

• Patients see an Action Required banner on the portal home page and sign from Forms in the portal menu.

• Staff assign a consent from the Forms tab of the Patient Communications panel in the chart, and countersign from there.

• Signed consents are filed to the patient's chart, and staff get a task when a patient accepts or declines.

Before you begin

• Choose which consents to offer. The plugin offers consents whose coding system is treatment-consent (or the systems in the TREATMENT_CONSENT_SYSTEM plugin secret) and that are set to show in the patient portal.

• Set up filing to the chart. Filing needs the CANVAS_FHIR_CLIENT_ID and CANVAS_FHIR_CLIENT_SECRET plugin secrets.

• To use DocuSign, your Canvas team adds the five DOCUSIGN_* connection secrets, and the three webhook secrets so signatures are picked up right away. See Plugin secrets in Patient Communications.

• Set up DocuSign for embedded signing. Patients sign inside Canvas, so DocuSign should not email them. Your Canvas team can help with the account settings.

How patients sign

Set up consents

1. In Notifications Admin, open the Consents tab. Each consent shows its name and code.

2. Under DocuSign template, pick the template the consent is signed with, or No template (portal signature pad).

   • If the list doesn't load, paste the template ID from DocuSign instead.

   • To create a new template, drop the consent PDF on the row, or click to choose it. The plugin creates a template named after the consent and opens DocuSign's editor in a pop-up. Place the signature fields, then click Save and Close in DocuSign. Allow pop-ups for Canvas if the editor doesn't open.

3. Check Assign to new patients to send the consent to every patient created from now on.

4. Check Requires provider countersignature if a provider signs after the patient. See Dual-signature consents below.

5. Click Save in the tab bar. Each row confirms what was saved.

Consents for new patients

Consents checked Assign to new patients go to each new patient when they are created. Patients created before you checked the box don't get them, and a patient who already has the consent assigned or accepted isn't sent it again.

New patient consents order lists these consents. Use Move up and Move down to set the order they are sent in.

To text or email new patients about their consents, turn on New Patient Consent Notifications on the Campaigns tab. It goes out once, within about 5 minutes of the patient being created, after their phone number and email are saved, and links to their portal Forms page. It doesn't name the consents. Patients created more than a day before are skipped.

Consents before a visit

On the Pre-Visit Forms tab, each visit type has a Consents list. Those consents are sent with the visit's forms, within the visit type's lead time. A patient who already has the consent assigned or accepted isn't sent it again. See Forms and Intake.

Assign a consent from the chart

1. Open the patient's chart, then Patient Communications > Forms.

2. Under Assign Consent, choose the Consent Form. Consents marked (Dual signature) also need a Countersigner.

3. Click Assign Consent.

If Form Assignment Notifications is on, the patient gets a text or email. Assigned Consents shows each consent's status: Pending, Awaiting countersignature, Accepted, Declined, or Countersignature declined. To remove a pending consent, click its ×.

What the patient sees

1. When a consent is waiting, the portal home page shows Action Required: "You have 1 consent form requiring your attention." The patient clicks Review Now, or opens Forms from the portal menu.

2. Consents are listed first on My Forms, most recently sent first. The patient clicks Review & Sign.

3. Signature pad: the patient reads the consent document, checks "I have read and understand the consent document above.", signs in the box, and clicks Accept & Sign, or clicks Decline.

4. DocuSign: the document opens inside the page. The patient signs and clicks Sign and Submit. If the session times out or they pause, they can open the document again from the same page.

5. Accepted consents with a signed copy appear under History, with View and Download.

Dual-signature consents

A dual-signature consent is signed by the patient first, then countersigned by a provider in DocuSign. It is filed to the chart once both have signed.

To turn it on for a consent, on the Consents tab:

1. Choose a DocuSign template with two signer roles named exactly Patient and Provider, with Provider signing second. Templates created from the tab are set up this way.

2. Check Requires provider countersignature.

3. Choose a Default Countersigner: an active staff member with an email address.

4. Optionally choose a Countersigner team; anyone on the team can also countersign.

5. Optionally check Route to the appointment provider so the provider on the patient's appointment countersigns, following reschedules. A consent sent without an appointment waits for the next appointment booked.

6. Click Save.

Who countersigns: the staff member chosen when assigning from the chart; otherwise the appointment's provider when routing is on; otherwise the Default Countersigner. Anyone on the countersigner team can also sign.

Countersigning:

1. When the patient signs, the countersigner gets a task Countersign consent: <consent name>, labeled consent-countersignature.

2. In the patient's chart, under Patient Communications > Forms > Assigned Consents, the consent shows Awaiting countersignature. Click Countersign.

3. Sign in the DocuSign window that opens. When you see Countersignature recorded., the signed consent is filed to the chart and the window closes.

If the appointment's provider changes, or the appointment is rescheduled or canceled, the countersignature task moves to the new provider when routing is on.

Where signed consents go

• DocuSign: the consent is recorded in the chart as accepted with the signed PDF attached, and the signed document is added to the patient's documents, dated the day the patient signed. A declined consent is recorded as declined.

• Signature pad: the consent is recorded in the chart as accepted or declined, with the consent's document attached.

• Staff task: a task Consent accepted: <consent> or Consent declined: <consent>, labeled paperwork-completed, goes to the appointment's provider or the staff member who assigned it. Consents sent to new patients have neither, so the task is unassigned. See Messaging and Tasks.

Troubleshooting