Online assessment in HOF: video pre-consultation and limits

Many patients arrive at the orofacial harmonization (HOF) practice having already exchanged messages, sent photos and asked for "an idea of the price" on WhatsApp. Some professionals answer for convenience, others refuse out of caution. The underlying question is the same: how far can an online assessment go before it becomes an improper act?

This guide organizes the subject in three layers: what telehealth rules generally say, what tends to work in practice as a pre-consultation, and how to protect both patient and professional. It is not a legal opinion and does not state what each professional may do: the rules change by council (CFO, CFM, CFBM, CFF, COFEN, the Brazilian federal councils for dentistry, medicine, biomedicine, pharmacy and nursing), and some were updated recently. Checking with your regional council is the final step.

What are telehealth and teleconsultation, in broad terms?

Telehealth is the delivery of health services at a distance, mediated by information and communication technologies. In Brazil, Law 14.510/2022 authorizes and governs the practice of telehealth across the national territory, and each council regulates what applies to its category. Some examples of the modalities the rules usually cover: teleconsultation, teleguidance, telemonitoring, telediagnosis and tele-interconsultation.

What the rules have in common is this: remote care has to follow the same ethical standards as in-person care, with confidentiality, records and consent, and it acknowledges the limitation of having no physical exam.

What do the councils say? Examples from two cases

Dentistry (CFO). CFO-SEC Resolution 278, of November 25, 2025, governs the practice of teledentistry (text on the CFO website) and revokes the previous resolutions on the subject. Among the points in the text: teledentistry is practiced exclusively by the dental surgeon; the professional must assess it as a complementary strategy to in-person care; the patient must be informed beforehand of the limitations, because a full physical exam is not possible; an informed consent form must be provided; the same rules as in-person care apply; and the chart, data retention and the LGPD (Brazil's General Data Protection Law) must be respected.

Medicine (CFM). CFM Resolution 2.314/2022 regulates telemedicine and stresses that the in-person consultation remains the reference in care. It allows the first consultation to be remote, with the decision and responsibility resting on the physician. Since rules can be updated, confirm the version in force on the CFM portal before applying it.

Other categories. For biomedicine, pharmacy and nursing, consult the respective federal council and the regional council to find out whether there is a specific rule for remote care and what it allows. Do not assume that one category's rule applies to another.

What fits in an online pre-consultation?

Separate, in your head and in your process, relationship and organization activities from clinical activities. The safest online pre-consultation usually stays in the first group:

For patients from another city, the flow can be: video pre-consultation, photos sent as instructed, and a scheduled day that combines the assessment and, if indicated, the procedure, with time set aside to talk, sign forms and decide without rushing.

How do you run a video pre-consultation?

A simple script, 15 to 20 minutes or whatever time the clinic decides:

1. Opening and consent. Introduce yourself, explain that the conversation is a pre-consultation, that it does not replace the in-person assessment, and ask for consent to the conversation and to the record. If the rule requires a written form, send it beforehand.
2. Listening. Ask what bothers the patient and what they expect, in their own words.
3. Brief history. Medications, allergies, pregnancy or breastfeeding, illnesses and previous procedures. Mark what needs to be confirmed in person.
4. Expectations and limits. Explain what is usually possible and what is not, without promising results. See patient objections and answers.
5. What the assessment will be like. Duration, what to bring, the photos that will be taken and how the plan will work.
6. Next step. Scheduling the in-person assessment and sending the forms and instructions.
7. Record. Write everything in the chart, with date, time, the medium used and consent.

What about the photos the patient sends?

A photo of a face is personal data and, once linked to a patient in a health context, it is sensitive data under the LGPD. Good practices:

• Tell the patient what the photo will be used for (assessment) and how long it will be kept.
• Record the consent before or at the time of sending. See consent and LGPD for photos.
• Use controlled channels (the clinic's system, a secure platform) instead of loose messages on a personal phone.
• Do not forward it, do not use it in marketing and do not store it in folders without access control.
• Ask for a standardized photo so that quality helps the assessment (lighting, framing, no filter), knowing that it does not replace the in-person exam.
• Define the deletion of received photos that will not be used, according to the clinic's policy and the chart retention rule.

Anyone who publishes a patient's results or images needs specific authorization. See the patient image use consent form.

Can I show a visual simulation online?

An illustrative simulation can help the conversation about expectations, but it must be presented as what it is: an illustration, with no promise of results and without replacing the assessment. Extra care is needed at a distance, because the patient may read a simulation as a commitment.

Prices and quotes: what to share before the assessment?

There is a difference between saying how the price is built and quoting a treatment. Stating, for example, that the price depends on the assessment, the amount of product, the number of areas and the follow-up is prudent and transparent. Sending a table of procedure prices, on the other hand, can run into your council's advertising rules and create the expectation of a plan that was never assessed. See advertising harmonization prices and how much does it cost in the DMs.

For the in-person assessment itself, which is usually a service with its own fee, see assessment consultation and the assessment consultation cost calculator.

Risks of deciding at a distance

• Wrong recommendation for lack of an exam, palpation and dynamic assessment.
• Inflated expectations when the patient reads the conversation as a commitment.
• Screening failure: conditions that only show up in the exam or in a detailed medical history.
• Data leaks from using insecure channels.
• Ethical and advertising issues if the pre-consultation is used as aggressive lead capture.
• Insufficient records, which makes it harder to defend yourself in case of a complaint. See charting and documentation in HOF.

Checklist before offering an online assessment

• Have I read my council's rule on remote care and confirmed the current version?
• Have I defined in writing what to do and what not to do at a distance?
• Do I have an informed consent form for remote care and for the use of photos?
• Does the channel I use protect the patient's data?
• Do I tell the patient about the limitations and refer them to the in-person assessment?
• Do I record the pre-consultation in the chart?
• Do I avoid recommending a procedure, volume or definitive quote without an exam?
• Does my communication respect the advertising rules?

The online assessment can be a good front door: it organizes expectations, shortens the consultation and helps those who live far away. It works best when it embraces its role of preparing the assessment, not replacing it.