Background:  New modes of service delivery have been implemented to meet the increasing demand for genetic services. In Australia genetic counseling for hereditary breast/ovarian cancer (HBOC) is available via videoconferencing for rural and outreach patients.  This study aimed to identify practitioner behaviors in telegenetics consultations that influenced patient outcomes. Methods: Seventy women attending telegenetics consultations, who were at moderate or high risk of HBOC, completed self report questionnaires pre-consultation and 1-month post consultation.  The telehealth appointments were digitally recorded and consultation content and clinician communication behaviors were analyzed. Results: Women who had more aspects of genetic testing discussed had a significant decrease in perceived personal control (β=-0.4, 95%CI=-0·798--0·015, p=0·04).  Women who had more aspects of breast cancer prevention discussed had a significant increase in breast cancer specific anxiety (β=3·6, 95%CI=0·583-6·62 p=0·02).  Support person presence, genetic counselor input, technical distractions, use of behaviors that encourage patient involvement, use of behaviors that facilitate understanding, partnership-building behaviors, supportive/counseling behaviors, and discussing screening, risk-reducing surgery, and genetics education, were not significantly associated with patient outcomes.  Conclusion: This study showed that while telegenetics improves patient outcomes, clinicians may need to reframe discussion of genetic testing in a way that empowers women and promotes a sense of personal control.