Client Consent Form                                                                           Private Pay Contract

 

Becoming a client with Second Medical Opinion, PLC, is easy. All necessary forms can be read and signed online, and you can pay confidently through our secure site. We have a Teleconsultation Room for  video-conferences with our Specialists.

Please make sure you read and understand the Client Consent Form and  the Private Pay Contract.

There are 2 services to choose from:

Conversation with Specialist (CwS℠). (This service does not include transmission of records or a written report)

By selecting this option you will be able to book a video-conference with a specialist in advance, in 15 minute intervals. For example, if you want to speak with the Specialist for 30 minutes, you will need to purchase two 15 minute intervals.

After providing payment and becoming a Client with Second Medical Opinions using Option 1 you will:

  • Receive an immediate “acknowledgement email” with receipt of payment. With the email, you will receive a pdf copy of the Client Consent Form, the Private Pay Contract and the Notice of Privacy Practices.
  • Be contacted within 1 business day to set up the video-conference interview appointment.
  • Receive an email with instructions to establish the video-conference connection.
  • Receive a closing email after the video-conference interview is completed.

 

Full  Specialist Service (FSS℠). (This service includes transmission of records or a written report)

After providing payment and becoming a Client with Second Medical Opinions with Option 2  you will:

  • Receive an immediate “acknowledgement email” with receipt of payment. With the email, you will receive a pdf copy of the Client Consent Form, the Private Pay Contract and the Notice of Privacy Practices.
  • Be contacted within 1 business day to set up first video-conference interview appointment.
  • Converse with the specialist of your choice by video-conference, relay information and questions.
  • Receive a secure fax number for private health information to be received during the reviewing process. We will provide you with an authorization form which directs the medical provider who has your records to send them to us. (Your provider may charge you a fee for this).
  • Rest assured while a complete review is underway, and a written report drafted.
  • Participate in a second video-conference interview with the specialist you chose for explanations and discussion of  issues.
  • Receive finalized written report via regular mail, and closing email.

Second Medical Opinions PLC works with a Private Pay Contract, we do not accept insurance and all payments must be made upfront.

The cost of receiving a second opinion depends on the chosen physician and the chosen option. Please see the staff page to select the physician of the speciality that you require.

Feel Comfortable Using Our Service. If you choose Option 1, you will talk with our Specialist  within 7 business days  of providing payment. If you choose Option 2, you will receive our written opinion within 21 days of us receiving all of the information needed to render our services. If you do not receive our opinion in the specified timeframes,  we will refund your payment. If you have any other problems with our service, please contact us, and we will be happy to discuss and respond promptly.

See our testimonials.

Call us with questions at (855) 798-3261