1. I voluntarily consent to any and all health care treatment and diagnostic procedures provided by FaceMyDoc and its associated physicians, clinicians and other personnel. I am aware that the practice of medicine and other health care professions is not an exact science and I further state that I understand that no guarantee has been or can be made as to the results of the treatments or examinations at FaceMyDoc.2. I agree to be contacted via email, phone or SMS with information related to my visit, like: a patient portal invitation, post-visit satisfaction survey, appointment or checkup reminders, health tips, or new services that relate to me or my family.3. I consent to the use and disclosure of my/the patient’s protected health information for purposes of obtaining payment for services rendered to me/the patient, treatment and health care operations consistent with the FaceMyDoc Notice of Privacy Practices.4. I authorize payment of medical benefits to FaceMyDoc physicians or their designee for services rendered.5. I give permission to obtain all my medication/prescription history when using an electronic system to process prescriptions for my medical treatment.
6. I agree to the Use of Services policy, Informed Consent to Telehealth policy and the Right of Payment, Patient Responsibility and Release of Information policy.
Upon clicking the submit button, this information will be forwarded to your selected provider. For immediate assistance, click for Text Help in the bottom left-hand corner of this page.