Remote Therapeutic Monitoring (RTM) & SMS Consent

Enrollment and electronic consent for outpatient psychiatric monitoring and symptom tracking.

About the Monitoring Program

Pittsburgh Psychiatry utilizes Remote Therapeutic Monitoring (RTM) to support your clinical treatment between regular appointments. Through this program, your doctor can track your symptom patterns, response to psychiatric medications, and therapeutic progress in real time.

How It Works:

Automated Check-in Links: You will receive periodic SMS text messages containing a secure link to brief, validated mental health assessments (e.g. PHQ-9, GAD-7, sleep, or mood scales).
Physician Review: Your responses are securely transmitted directly to Dr. Dombrovski or Dr. Ivanov to guide treatment adjustments, medication titration, and follow-up planning.
Zero Health Data over SMS: SMS messages contain only secure access links; no personal medical information or diagnosis is ever sent in plain text.

⚠️ Emergency Notice: Remote Therapeutic Monitoring is not an emergency crisis service and is not monitored 24/7. If you are experiencing suicidal thoughts, severe psychiatric distress, or a medical emergency, please call 911 or call/text the Suicide & Crisis Lifeline at 988 immediately.

Electronic Enrollment

Patient Consent & SMS Opt-In Form

Please complete the form below to enroll in Remote Therapeutic Monitoring with your treating psychiatrist.

Patient Full NameDate of BirthMobile Phone Number (Optional for SMS check-ins)Standard text message and data rates may apply if SMS consent is selected.Email AddressTreating Psychiatrist

(Optional) SMS Communication Consent: I agree to receive transactional Remote Therapeutic Monitoring (RTM) check-ins, symptom assessment links, and appointment notifications via SMS from Pittsburgh Psychiatry at the mobile phone number provided above. I understand that message frequency varies based on my clinical care plan (typically 1–2 check-ins per week). Message and data rates may apply. I can opt out at any time by replying STOP, or get help by replying HELP or calling 412-345-3517. I agree to the Terms of Service and Privacy Policy. Mobile information will not be sold, rented, or shared with third parties or affiliates for marketing or promotional purposes. SMS consent is completely optional and not required to receive care.

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