What consent do telemedicine and AI need under CFM rules?

A teleconsultation needs the patient's voluntary and informed agreement (consentimento livre e esclarecido), sent electronically or recorded as a reading of the text, kept in the patient's electronic record, under article 15 of Resolução CFM 2.314/2022. Since late August 2026, Resolução CFM 2.454/2026 also gives the patient the right to be told when AI plays a relevant part in their care and to refuse it, and asks the doctor to record AI used as decision support in the prontuário.

Telemedicine under Resolução CFM 2.314/2022

Telemedicine is allowed across Brazil, and the in-person consultation stays the reference standard. A teleconsultation is recorded in the patient's record, and an electronic record system used for it must meet security level NGS2 with ICP-Brasil or another legally accepted standard.¹ For long-term or chronic conditions, the patient sees their doctor in person at intervals of no more than 180 days. A report, certificate or prescription issued remotely carries the doctor's name, CRM and address, the patient's details, the date and time, an ICP-Brasil digital signature and a note that it was issued by telemedicine.¹

The patient or their representative authorises the telemedicine visit and the transmission of their images and data through a voluntary and informed term of agreement, sent electronically or recorded as a reading of the text, which becomes part of their electronic record. The consent must be explicit, and the patient is told that their information may be shared and that they may refuse, except in an emergency.¹ The patient may ask for a digital or printed copy of their record.¹

AI under Resolução CFM 2.454/2026

Resolução CFM 2.454 was published on 27 February 2026 and took effect 180 days later.² It treats AI only as a support tool, keeps the doctor finally responsible for clinical, diagnostic, therapeutic and prognostic decisions, and asks the doctor to record in the prontuário when AI supported a medical decision.² The patient has the right to be told clearly when AI is a relevant support in their care, the doctor must respect an informed refusal, and the doctor may not hand the communication of a diagnosis, prognosis or treatment decision to AI without human mediation.² Institutions that use AI assess its risk level first, and those that adopt their own AI systems form a Comissão de IA e Telemedicina under medical coordination. The CRMs supervise compliance.²

1. Write one consent text. Cover the teleconsultation, the sharing of data and the patient's right to refuse.
2. Add the AI line. Say that AI supports note writing, that the doctor decides and signs, and that the patient may refuse.
3. Capture it electronically. Sent electronically or as a recorded reading, kept in the patient's record.
4. Record AI use in the note. When AI supported a decision, the prontuário says so.
5. Keep a person in every message. No diagnosis, prognosis or treatment decision reaches the patient from AI alone.
6. Schedule the in-person visit. For chronic care, an in-person consultation at least every 180 days.

1. I agree to be seen by teleconsultation on ______
2. I understand my data may be shared for my care, and I may refuse ______
3. The clinic uses AI to help write notes. My doctor reviews, decides and signs ______
4. I may refuse the use of AI in my care ______
5. Recorded by ______ Date and time ______

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Questions

Does the CFM allow AI scribes?

Resolução CFM 2.454/2026 allows AI as a support tool under human supervision, with the doctor fully responsible, the patient informed and able to refuse, and the use recorded in the prontuário.

Can a first consultation be by video?

Yes, Resolução CFM 2.314/2022 allows the relationship to start virtually, with follow-up in person.

Where is telemedicine consent kept?

In the patient's electronic record, as a term sent electronically or a recorded reading of the text.

Since when does the AI resolution apply?

It was published on 27 February 2026 and took effect 180 days later, in late August 2026.

Sources

1. 1Conselho Federal de Medicina, 2022Resolução CFM nº 2.314/2022, define e regulamenta a telemedicinaRead source
2. 2Conselho Federal de Medicina, 2026Resolução CFM nº 2.454, de 11 de fevereiro de 2026, normatiza o uso da inteligência artificial na medicinaRead source
3. 3Conselho Federal de Medicina, 2018Resolução CFM nº 2.217/2018, Código de Ética MédicaRead source

Written by the wai team from ANVISA and the vigilância sanitária, the Conselho Federal de Medicina and the CRMs, and the Organização Nacional de Acreditação guidance, checked on 16 October 2026. This is guidance, not legal advice. Neither ANVISA, the CFM nor ONA endorses wai or any software.