E2NDOPINION Services Agreement

  • This Services Agreement is entered, effective on the date the agreement is signed by the patient, between “Patient” (name listed under “Name of Patient”) and E2NDOPINION. E2NDOPINION provides second opinion via panel of physicians volunteering for E2NDOPINION and selected by the patient(s). In exchange for certain fees paid by Patient to E2NDOPINION, patient will be given second opinion via email/video conference/phone call but never in person by the physician he selects or if that physician is unavailable physician specializing in a similar field will be contacted to give second opinion.

 

  • The patient agrees to pay E2NDOPINION the agreed upon listed fees, As the physicians are volunteering and E2NDOPINION is a nonprofit. These fees will be for cost incurred by E2NDOPINION.

 

  • This agreement is not a substitute for health insurance.  Patient acknowledges that the E2NDOPINION does not practice participates in any insurance or HMO plans.  Physician has opted 

             

  • This Agreement will be effective on the date written above and it will extend through the end of the calendar year.  It may be terminated without showing cause with a 30-day prior written notice by E2NDOPINION and/or Patient.  The Agreement shall be terminated upon the death of either Patient.  The Agreement will automatically be renewed at the end of each calendar year. The following are examples or reasons that the Practice may wish to terminate the  Agreement with the Patient.  

    1. The Patient fails to pay applicable fees.

    2. The Patient has performed an act that constitutes fraud;

    3. The Patient is abusive, or presents an emotional or physical danger to the E2NDOPINION whether they are volunteers, staff, other patients’ co-founder, board of directors, CEO/president

    4. E2NDOPINION discontinues operation;

    5. E2NDOPINION practice has a right to determine whom to accept as a patient, just as a patient has the right to choose his or her physician/establishment like E2NDOPINION

    6. The Practice may also terminate a patient without cause as long as the termination is handled appropriately      

  • The Patient Acknowledges that this agreement is a legal document and creates certain rights and responsibilities.  You also acknowledge that you have a right to seek legal counsel regarding this Agreement and either have chosen not to do so or have done so and are satisfied with the terms and conditions of the agreement.  

             

  • Patient also acknowledges that the E2NDOPINION has the right to amend this agreement by notifying Patient in writing of the proposed amendments, which will become effective as soon as the email has been sent.  Patient will be deemed to have agreed to the amendment unless Patient notifies E2NDOPINION in writing that he or she does not agree to such amendment, in which event this agreement will be terminate immediately and Patient will no longer be able to use E2NDOPINION to avail second opinion form the physicians volunteering via E2NDOPINION platform.

             

  • Patient acknowledges that communications with the Physician using e-mail, facsimile, video   chat, instant messaging and cell phone are not guaranteed to be secure or confidential methods of communications.  The practice will make an effort to secure all communications via  passwords and other protective means and these will be discussed in an annually updated Health Insurance Portability and Accountability Act (HIPPA)

  • Patient Understandings/;-

  1. This agreement is for second opinion and in no way replaces primary care and is NOT a medical insurance agreement.                                                                                                                               

  2. In the event I have a complaint about the practice I will first notify the Practice directly. 

  3. I am enrolling (myself and my family if applicable) in the practice voluntarily.  

  4. This Agreement is non-transferable.