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Telemedicine Intake and Consent

By clicking submit, I am acknowledging that I understand this is not an appropriate avenue to seek emergent medical care. I also understand that telemedicine visits can not be as thorough as a traditional physical doctor visit. I understand that there is no guarantee of a specific prescription and the need for antibiotics will be determined by the doctor's best judgment. I understand that further testing may be required and a physical visit may be recommended. The doctor may also determine the severity of the problem warrants a visit to the ER or urgent care. I also consent to the usage of my or my dependant's personal information including identifying information such as name, DOB, phone number, and email in the process of providing telemedicine care. I consent to electronic communications and sharing of personal identifying information with necessary third-parties such as pharmacies and other healthcare entities.

Thank you for signing up!

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