I understand that telemedicine or telehealth is the use of electronic information and communication technologies by a health care provider to deliver services to an individual when he/she is located at a different site than the provider.
I understand that telemedicine or telehealth visits are reserved for mild to moderate medications and may not be appropriate for severe or life-threatening illnesses.
I understand that medical evaluation, diagnosis and treatment offered on CallonDoc.com are virtual or asynchronous in the absence of a face to face physical examination.
I agree to follow up with a doctor in-person or seek emergency care after a telemedicine for further evaluation of your condition or sooner if symptoms do not improve or resolve in a timely manner.
I agree to call 911 or seek emergency care if your symptoms or condition worsen or immediate medical is required after your telemedicine visit.
I agree to continue the recommended routine physical visit with an in-person physician while utilizing telemedicine as secondary means of accessing healthcare.
I certify that I do not have any cognitive impairment and capable of making sound medical decisions.
I understand that I'm engaging in telemedicine (telehealth) consultation and I accept the risk of misdiagnoses due to the absence of in-person evaluation or diagnostic tools.
I certify that I must be an adult patient or an adult legal guardian of a minor patient to use the Callondoc.com platform.
I understand that services rendered by Callondoc are provided on a non-refundable basis.
I understand that my payment to Callondoc.com, the consultation fee, may not cover the prescribed medication and I still have to pay for the prescribe medication at the pharmacy.
I understand that the information given on the medical intake form must be complete, accurate and up-to-date to the best of my knowledge.
I understand that my failure to provide a complete, accurate and truthful information on the intake form puts me at a harmful risk of misdiagnosis and incomplete treatment.
I understand that Callondoc reserves the right to decline treatment if misleading pieces of information are given by the patient or user.
I hereby acknowledge that providing my personal information to Callondoc.com is voluntary, and is required as a personal identifier to deliver. medical services.
I understand that I am establishing a Provider-Patient relationship via telemedicine and/or telehealth. That I have read or had this form read and/or had this form explained to me, and I fully agree with the contents. That I fully understand and agree with its contents including the risks and benefits of telemedicine. That I have been given ample opportunity to ask questions and that any questions have been answered to your satisfaction.