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.