NOTICE TO PATIENTS:
Please print out, sign and email (Waterviewpatients@gmail.com) or fax (289-245-1486) to our office, to allow us to communicate with you electronically. PLEASE MAKE SURE YOU INDICATE ON THE FORM THE EMAIL YOU WISH THE CLINIC TO USE.
Important: If you cannot download the consent form and email the signed consent form back to us, then please email the following text back to the clinic to be added to your chart. This will serve as your consent for electronic communications until you visit the clinic in person and can sign the consent form in the office:
“I (first, last name, date of birth), a patient of Dr. (name) have read the electronic consent form posted on the Waterview Medical Website and agree to the terms and conditions outlined. I wish to use the email:______________________”.
Important conditions of using the Services of electronic communication with your physician: 1) While the Physician will attempt to review and respond in a timely fashion to your electronic communication, the Physician cannot guarantee that all electronic communications will be reviewed and responded to within any specific period of time. The Services will not be used for medical emergencies or other time-sensitive matters; 2) If your electronic communication requires or invites a response from the Physician and you have not received a response within a reasonable time period, it is your responsibility to follow up to determine whether the intended recipient received the electronic communication and when the recipient will respond; 3) Electronic communication is not an appropriate substitute for in-person or over-the-telephone communication or clinical examinations, where appropriate, or for attending the Emergency Department when needed. You are responsible for following up on the Physician’s electronic communication and for scheduling appointments where warranted.
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