On Call Telehealth

Welcome to our online Telehealth Platform through Doxy.me

If your issue is occurring during regular office hours please call the office at 425-885-3574 before initiating a Telehealth consult.

We are reserving this service for after-hours and weekend EMERGENCIES only.

If you are looking to schedule an appointment for an eye exam, need documents or records, or would like to order glasses or contact lenses, please contact the office directly by phone or email.

Telehealth services are only available for current patients of Redmond Eye Clinic and is therefore unfortunately not available to new patients at this time. If you are a new patient and are having an eye emergency, please visit your local urgent care immediately. If you have medical insurance, please be sure to enter it correctly in the form below as it will be billed for this service.

If this is an after hours or weekend emergency, please contact us on Doxy.me by filling out the form below in its entirety.

After completing the form and agreeing to the consent, you will be redirected to our telehealth waiting room.

Telehealth Form

"*" indicates required fields

Patient Details

Name*

First Last

Date of Birth*

Email

Phone*

Patient Address

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Insurance Information

Insurance Information*

Insurance Name Member ID

Reason for Telehealth Consult*

Consent*

I agree to the consent form and billing policies of Redmond Eye Clinic as described below.

Informed Consent for Telehealth Services

Definition of Telehealth: Telehealth involves the use of electronic communications to enable Redmond Eye Clinic clinicians to connect with individuals using live interactive video and audio communications. Telehealth includes the practice of health care delivery, diagnosis, consultation, treatment, referral to resources, education, and the transfer of medical and clinical data.

I understand that I have the following rights with respect to telehealth:
1.The laws that protect the confidentiality of my personal information that I have already signed also apply to telehealth. Copy of our Office Policies and Therapeutic Informed Consent can be provided.
2. I understand that I have the right to withhold or withdraw my consent to the use of telehealth in the course of my care at any time, without affecting my right to future care or treatment.
3. I understand that there are risks and consequences from telehealth, including, but not limited to,
the possibility, despite reasonable efforts on the part of the clinician, that: the transmission of my personal information could be disrupted or distorted by technical failures, the transmission of my personal information could be interrupted by unauthorized persons, and/or the electronic storage of my personal information could be unintentionally lost or accessed by unauthorized persons. Redmond Eye Clinic utilizes secure, encrypted HIPAA compliant audio/video transmission software to deliver telehealth via Doxy.me.
4. By agreeing to this document, I understand that certain situations, including emergencies and crises, are inappropriate for audio-/video-/computer-based healthcare services. If I am in crisis or in an emergency, I should immediately call 9-1-1 or seek help from a hospital or crisis-oriented healthcare facility in my immediate area.

Payment for Telehealth Services:
Redmond Eye Clinic will bill insurance for telehealth services which are subject to our standard billing practices. By agreeing to use telehealth services you are also agreeing to provide complete and accurate insurance information. The standard copay and/or deductibles would apply. In the event that insurance does not cover telehealth, you may be responsible for the cost for telehealth services. We can provide you with a statement of service to submit to your insurance company.

Patient Consent to the Use of Telehealth:
I have read and understand the information provided above regarding telehealth. I have read this document carefully and understand the risks and benefits related to the use of telehealth services and have had my questions regarding healthcare through telehealth explained. I hereby give my informed consent to participate in the use of telehealth services for treatment under the terms described herein. By checking the consent box above and/or clicking the take me to telehealth button below, I hereby state that I have read, understood, and agree to the terms of this document.

Top Frame Lines

Terms of Use | Privacy Policy | Accessibility

Copyright © 2024 Redmond Eye Clinic. Site by CloveRock Design