Form preview

Get the free Remote Second Opinion Program Patient Disclaimer - hopkinsmedicine

Get Form
This document outlines the terms and conditions for the use of the Remote Second Opinion service provided by the Johns Hopkins Department of Neurosurgery, highlighting the limitations and risks associated
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign remote second opinion program

Edit
Edit your remote second opinion program form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your remote second opinion program form via URL. You can also download, print, or export forms to your preferred cloud storage service.

Editing remote second opinion program online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Follow the guidelines below to benefit from a competent PDF editor:
1
Register the account. Begin by clicking Start Free Trial and create a profile if you are a new user.
2
Simply add a document. Select Add New from your Dashboard and import a file into the system by uploading it from your device or importing it via the cloud, online, or internal mail. Then click Begin editing.
3
Edit remote second opinion program. Text may be added and replaced, new objects can be included, pages can be rearranged, watermarks and page numbers can be added, and so on. When you're done editing, click Done and then go to the Documents tab to combine, divide, lock, or unlock the file.
4
Save your file. Select it from your list of records. Then, move your cursor to the right toolbar and choose one of the exporting options. You can save it in multiple formats, download it as a PDF, send it by email, or store it in the cloud, among other things.
With pdfFiller, dealing with documents is always straightforward.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out remote second opinion program

Illustration

How to fill out Remote Second Opinion Program Patient Disclaimer

01
Download the Remote Second Opinion Program Patient Disclaimer form from the program's website.
02
Begin by entering your personal details such as your name, date of birth, and contact information.
03
Review the purpose of the Remote Second Opinion Program outlined in the form.
04
Read through the terms and conditions of participation in the program carefully.
05
Indicate your consent by signing and dating the form at the bottom.
06
If applicable, provide the information of any authorized representatives or power of attorney.
07
Submit the completed form via the indicated method (email, online upload, or mail) as per the program's instructions.

Who needs Remote Second Opinion Program Patient Disclaimer?

01
Individuals seeking a second opinion on a medical diagnosis or treatment plan.
02
Patients who are considering participating in remote medical consultations.
03
Those who have specific health conditions that require additional evaluation.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.5
Satisfied
61 Votes

People Also Ask about

After reviewing your diagnostic tests, our specialists provide a written second-opinion interpretation to you and your referring physician for X-rays, CTs, MRIs, PET scans and ultrasound exams. Your interpretation is provided by a radiologist with specialty training in the area of the body being studied.
“Doctor, I trust you and appreciate your help thus far, but this is all so new to me and I feel that a second opinion could help me make sense of everything.” “I want to go into treatment with some reassurance that my pathology report is correct and I have explored all treatment options.
Begin the conversation by saying that you feel your request is reasonable and ask him why he thinks a second opinion isn't necessary. Ask him to also explain what was found in your ultrasound test. And ask what can be done to alleviate your current symptoms.
Be honest and straightforward; most physicians will respect their patients' right to a second opinion. Be sure to ask for your medical records so you can share them with the physician giving the second opinion. By law, your physician must provide these records to you, although you may have to pay a fee.
to confirm your diagnosis. to find out if there are other treatment options. to support what you have already been told about your condition and treatment. because you don't feel that you can talk to your current doctor.
Doctors don't care if you get a second opinion. Our office encourages it for people who do not quite believe or can't accept a diagnosis. It doesn't matter if they find out.

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

The Remote Second Opinion Program Patient Disclaimer is a document that informs patients about the nature of the second opinion services they will receive, including limitations and the importance of using it alongside their primary care.
Patients seeking a second opinion through the Remote Second Opinion Program are required to file the Patient Disclaimer.
To fill out the Remote Second Opinion Program Patient Disclaimer, patients must provide their personal information, details about their medical condition, and acknowledge their understanding of the program's limitations by signing the document.
The purpose of the Remote Second Opinion Program Patient Disclaimer is to ensure that patients are fully informed of the services provided and to limit liability for the providers, while also emphasizing the importance of ongoing communication with their primary healthcare provider.
The information that must be reported includes patient identity, detailed medical history, the specific condition or treatment in question, and an acknowledgment of understanding the program's terms and limitations.
Fill out your remote second opinion program online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.