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 Form is 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
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