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Telehealth Consent Form

  1. I hereby authorize Health Care Services to use the telehealth practice platform for telecommunication for evaluating, testing and diagnosing my medical condition.
  2. I understand that technical difficulties may occur before or during the telehealth sessions and my appointment cannot be started or ended as intended.
  3. I accept that the professionals can contact interactive sessions with video call; however, I am informed that the sessions can be conducted via regular voice communication if the technical requirements such as internet speed cannot be met.
  4. I understand that my current insurance may not cover the additional fees of the telehealth practices and I may be responsible for any fee that my insurance company does not cover.
  5. I agree that my medical records on telehealth can be kept for further evaluation, analysis and documentation, and in all of these, my information will be kept private.

Benefits Of It

A medical second opinion gives you a new perspective, confidence, peace of mind on the health situation at hand. It provides clarity and options on current course of treatment. At times there can be several ways to treat a specific condition. Now you can access a second opinion from the best USA hospitals in the world without the need of flying and spending a fortune

When You Need It

  • Your diagnosis is unclear

  • You’re not responding to a treatment as expected

  • Doctor mentions the following words: Rare, Life-Threatening or Risky

  • You’ve lost confidence in your medical care provider

Second Opinion

The opinion of a doctor other than the patient’s current doctor is Second Opinion. The second doctor reviews the patient’s medical records and gives an opinion about the patient’s health problem, diagnosis and how it should be treated.

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