WalshDoc

Telemedicine Consent, Intake Authorization, and Practice Policies

Consent version: SOP-WD-CONSENT-v1.0-2026-05-05
This service is not for emergencies. Do not use this questionnaire for urgent or life-threatening symptoms. If you are having a medical emergency, call 911 or seek emergency care immediately.
This consent applies to telemedicine-based assessment, questionnaire review, lab review, biochemical/nutritional interpretation, report preparation, and related Second Opinion Physician / WalshDoc services. By continuing, you acknowledge that you have read and agree to these policies and authorize Second Opinion Physician / WalshDoc to receive and review the information you submit.
Your submitted information is transmitted through a secure HTTPS connection and reviewed through restricted clinician access. Do not use this form for emergencies.
You may also review our Notice of Privacy Practices, which describes how health information may be used, disclosed, and protected.

1. Nature of services

Second Opinion Physician / WalshDoc provides telemedicine-based, second-opinion style assessment services. These services may include health questionnaires, review of symptoms and history, review of laboratory information, biochemical and nutritional interpretation, educational discussion, report preparation, and related next-step recommendations.

2. Not primary care

Second Opinion Physician / WalshDoc does not replace your primary care provider. You should maintain an ongoing relationship with a primary care physician and appropriate specialists for routine care, urgent care, medication management, physical examinations, diagnosis, monitoring, and treatment of medical conditions.

3. Not emergency or urgent care

This service is not designed for urgent symptoms, crisis situations, suicidal intent, severe psychiatric instability, chest pain, stroke symptoms, severe allergic reactions, severe infection, or any other emergency. If urgent or emergency symptoms occur, seek emergency care immediately.

4. Medication limitations

Second Opinion Physician / WalshDoc generally does not prescribe or manage medications and does not replace the clinician who manages your medications. Medication questions, medication changes, medication side effects, and medication emergencies should be handled with your prescribing clinician, primary care provider, specialist, urgent care, or emergency services as appropriate.

5. Lab testing and lab interpretation

Lab testing may be recommended or reviewed as part of the assessment process. Lab interpretation is provided in the context of the information submitted and is not a substitute for full in-person evaluation when needed. Abnormal or urgent lab findings should be reviewed with your primary care provider or appropriate specialist.

6. Supplement, nutrition, and lifestyle recommendations

Recommendations may include nutritional, supplement, dietary, lifestyle, or retesting suggestions. Supplement recommendations, if provided, should be considered in the context of your medical history, medications, allergies, pregnancy status, age, weight, sensitivity/reactivity, and current clinician guidance.

6A. Supplement source and financial disclosure

Second Opinion Physician / WalshDoc may recommend nutritional supplements, including products available through BiotypeNutrients.com. BiotypeNutrients.com is owned by or affiliated with Second Opinion Physician, and Second Opinion Physician may receive profit from purchases made through that site.

You are not required to purchase supplements from BiotypeNutrients.com. You may purchase comparable products from another source if you prefer. Your access to Second Opinion Physician / WalshDoc services is not conditioned on purchasing supplements from BiotypeNutrients.com.

Supplement recommendations are provided for clinical and educational purposes and should be considered in the context of your medical history, medications, allergies, pregnancy status, age, weight, sensitivity/reactivity, and current clinician guidance.

7. Private-pay / no insurance billing

Second Opinion Physician / WalshDoc services are private-pay services unless otherwise stated. We do not bill insurance for these services. You are responsible for any applicable fees for assessments, reports, consultations, lab ordering, lab interpretation, supplement strategy, follow-up reports, or physician review.

8. Telemedicine limitations

Telemedicine has limitations. Information may be incomplete, technology may fail, and remote assessment cannot replace a physical examination or emergency evaluation. You are responsible for providing accurate information and for seeking in-person care when needed.

9. Patient responsibility

You agree to provide accurate and complete information, including current medications, supplements, allergies, pregnancy status when applicable, medical conditions, relevant labs, and the name of your primary care provider or treating clinician when requested. You remain responsible for follow-up with your primary care provider and specialists.

10. Privacy, HIPAA, and electronic health information

Second Opinion Physician / WalshDoc receives and reviews health information submitted through this questionnaire for assessment, report preparation, follow-up, and related clinical or administrative purposes.

Second Opinion Physician / WalshDoc is intended to operate with privacy and security safeguards for protected health information, including HTTPS encryption for submitted information, restricted clinician access, and controlled report review workflows.

WalshDoc uses AWS hosting infrastructure under an active AWS Business Associate Addendum. However, no electronic system can be guaranteed to be risk-free. Patients should not submit emergency information through this system.

By submitting this questionnaire, you authorize Second Opinion Physician / WalshDoc to receive, store, and review the information you provide for the purpose of preparing an assessment, report, lab recommendation, supplement strategy, follow-up plan, or related clinical communication.

11. Software-assisted report generation

WalshDoc may use software-assisted scoring, structured logic, and report-generation tools to organize questionnaire responses, lab values, and assessment language. Reports and recommendations should be reviewed according to the service tier selected and are not intended to replace physician judgment.

12. Report review and release policy

After you submit a questionnaire, a report may be generated for clinician review. The report will not necessarily be displayed to you immediately. Depending on the service selected, the report may require clinician review, lab entry, physician review, or additional information before release.

13. Repeat questionnaires and consent status

If you complete repeat questionnaires or follow-up forms, your prior consent status may be shown as already accepted. You may review this consent at any time. Re-acceptance may be required if the consent version changes, a new service type is added, or your consent status is not available.

14. Consent to proceed

By checking the box below and continuing, you acknowledge that you have read and agree to this Telemedicine Consent, Intake Authorization, and Practice Policies. You authorize Second Opinion Physician / WalshDoc to receive and review the information you submit.

Cancel / Return
You must check the consent box before continuing.