Service Type: TeleConsult

Upon receiving the eligibility consent and payment, the doctor will exercise their professional clinical judgement in assessing your suitability for tele-consult. They may decide to:

1.  Recommend an in-person consultation if the case is not appropriate for a tele-consultation.
2. Withhold prescriptions or recommendations until an in-person examination is completed.

The patient acknowledges that there are limitations of teleconsultation and accepts that medical decisions made under these circumstances are not grounds for dispute or legal recourse.

You may make payment using one of the following methods:

• PayNow
• Bank Transfer

An email containing the payment instructions will be sent to you upon completion and submission of this form.

Please note that consultation fees are non-refundable once payment has been made, regardless of attendance or the recommendations provided during your session.

Please select two (2) preferred time slots. We will confirm your final appointment timing after payment has been received and processed. Note: All appointments are scheduled only on weekdays and are based on availability.

By submitting this form, I confirm that:

• I have read and understood all the information provided above.
• I voluntarily consent to proceed with the Teleconsult via Plato Connect.
• I understand that technical or clinical limitations may impact outcomes, and I will not hold the doctors or clinic liable for outcomes reasonably constrained by the telemedicine medium.
• I understand that the Teleconsult will be conducted via a secure, MOH-compliant video platform, and recordings of the consultation is NOT permitted 
• I understand that a teleconsultation may not provide the same level of assessment as an in-person consultation. If the doctor determines that an in-person visit is necessary, I will be advised accordingly.
• I understand that the teleconsultation will be limited to a maximum duration of 30 minutes. If the session exceeds this time, additional consultation charges may apply.
• I am aware that if I am more than 10 minutes late, the session may be rescheduled.
• I agree to the collection, use, and disclosure of my personal and medical data for the purposes of clinical care, in accordance with PDPA and MOH regulations.
• A maximum of 1 rescheduling allowed. Subsequent rescheduling will be subjected to a $27.25 (inclusive of 9% GST) administrative fee per reschedule.
• I understand that consultation fees are non-refundable once payment has been made, regardless of attendance or the advice provided during the teleconsultation.