NEVER REQUEST AN ELECTRONIC VISIT FOR AN URGENT MEDICAL PROBLEM, CALL 911 INSTEAD.

By requesting a virtual e-visit, the patient agrees to the service terms, privacy policy, and charges for receiving a virtual visit from our medical provider at Anuli Aesthetics. Requests for e-visits must be confirmed and scheduled by our office prior to the e-visit. Before the visit, please fill out our medical questionnaire. After reviewing your information, or during the e-visit, it may be determined that your issue is too complex for an e-visit. In this case, our office will schedule you for a traditional office visit, and your e-visit fee will be applied to the patient balance related to your office visit. Our provider will appropriately document the virtual e-visit, including all relevant communication, in the patient’s medical/health record. The provider has a defined time frame within which responses to a virtual e-visit request are completed. During the virtual e-visit, the provider may make recommendations, provide medical advice, and/or prescribe, refill, or recommend medications. The provider may suggest the patient receive additional care, examination, testing, and/or treatment at a medical facility in person. If necessary, the provider may also suggest that the patient receive care in an emergency room. Communication during an e-visit may take place via teleconference, landline phone, cellular phone, and online chat in accordance with the State of Texas regulations. By requesting an e-visit, you acknowledge that personal health information will be communicated. A virtual e-visit may include the total interchange of online inquiries and other communications related to this single patient encounter, as determined by the provider. As with any medical service, decision, or treatment, there are risks; and an e-visit is no different. Because this visit is electronic and not in person, you acknowledge that the risk may be greater than a traditional office visit, and by requesting the visit, you agree to accept the outcome—even if it is undesirable. Additionally, you agree to abide by our office’s routine policies, including any policy related to litigation.

I acknowledge I am paying for a telemedicine consult with the medical provider, and the outcome will be based solely on the providers medical discretion, and the fee is non-refundable.

N. Anyanwu
Clinical Director
Anuli Aesthetics & Weightloss

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