READ CAREFULLY BEFORE YOU REQUEST A VIRTUAL EVALUATION: OUR RATES
WE USE ZOOM FOR ALL OUR PLATFORM. Zoom will allow also to share our screen for your education. If you prefer a different Face to Face method, please let us know.
First, contact Dr. Rifai or, you may e-mail: TheVirtualNephrologist@gmail.com requesting an appointment for a VIRTUAL CONSULTATION in the subject line
Then, download form 1 and keep for your records. You may read and understand at your leisure.
Then, download form 2 and complete, sign and e-mail to us. You may also fax to +1 (850) 914.3004.
Then, download forms 3 & 4 and keep for your records. You may read and understand at your leisure.
This is the: COMPREHENSIVE MEDICAL HISTORY FORM
DOWNLOAD THE Comprehensive Medical Form, take the time to complete clearly and attach any labs or X rays or ultrasound reports. Fax or email back to us with a cover letter.
- 1- HIPAA and Privacy Practices Notice for TVN
- 2-HIPAA and Privacy Practices RECEIPT for TVN
- 3- Terms of Service for TVN
- 4- Third Party advertisements policy for TVN