Paper, Pixels, and Patient Protection

Hot Topics from the KMC University HelpDesk

Informed consent is a legal and ethical cornerstone of healthcare—and chiropractic care is no exception. But as more clinics move toward paperless systems, a common question arises:

Can a digital signature truly replace the traditional in-person, pen-on-paper consent?

The short answer? Yes — but only if you do it right.

Understanding the Purpose of Informed Consent

Informed consent isn’t just a signed form—it’s a dynamic process of communication between provider and patient. Chiropractors are responsible for making sure patients:

  • Understand the proposed treatment or procedure
  • Are aware of the potential risks and benefits
  • Know their options, including alternative treatments
  • Agree to care voluntarily and without coercion

This conversation, whether verbal or written, empowers patients to make informed decisions and protects both parties.

The Rise of Electronic Consent in Chiropractic

With advances in technology, electronic signatures are now legally recognized under the ESIGN Act and UETA (Uniform Electronic Transactions Act). That means chiropractors can legally obtain informed consent through digital forms, provided key conditions are met:

  • The patient intends to sign electronically
  • The system secures their agreement to use digital records
  • The platform complies with HIPAA for handling Protected Health Information (PHI)

This is great news for practices using online intake forms and telehealth—but there’s more to consider.

Don’t Skip the Verbal Conversation

Even if your patient signs a compliant digital form, that doesn’t replace the need for verbal communication. In fact, several states—like California—require both verbal and written consent, especially before certain procedures.

Even when not legally required, having a clear verbal explanation helps ensure patient understanding and minimizes liability. When in-person conversations aren’t feasible, telehealth platforms or secure phone consultations are valid alternatives.

Compliance Varies by State—Know Your Laws

Informed consent laws differ widely across the country. Some states allow digital-only consent; others require in-person documentation. Chiropractors must stay up to date on the regulations in their specific state and consult a healthcare attorney when needed.

Best Practices for Informed Consent in Chiropractic

Whether you use paper or pixels, your informed consent process should include:

  • Clear, jargon-free explanations
  • Visual aids to support understanding
  • Opportunity for patient questions
  • Documentation of the discussion in the patient’s record
  • Platforms that comply with HIPAA, ESIGN, and UETA (when using electronic forms)
  • “Teach-back” methods to confirm patient understanding

Bottom Line: It’s More Than a Signature

Electronic signatures are a convenient and legally sound way to document consent—but they’re not a substitute for clear communication.

To stay compliant and build trust with your patients, your process must reflect both legal standards and best clinical practices.