Briarvista Pediatrics Logo

Telemedicine Consent

By clicking “I agree” below and using our telemedicine service:

  • You agree to have us charge your regular office visit copay, if required by your insurance, to your credit card on file.
    • Please note that if the visit goes toward patient responsibility (deductible/coinsurance), our regular financial policies will apply regarding payments.
    • If you do not have a credit card on file, you must either provide one (per office policy), or pay your copay online before you continue.
  • You agree to login at your assigned time, with your child nearby, and wait for Dr. Wexler to appear on the site.
  • If you are not available when Dr. Wexler logs on, this visit will be counted as  “no-show” and regular office policies will apply.
    • Patients not already logged in when Dr. Wexler becomes available will have their visits canceled and may be charged a $25 cancellation fee.
  • You understand that telemedicine has limits and can not always replace an in-office visit, but you are willing to accept all risks associated with these limits.
  • You consent to treatment via the telemedicine platform as per your already signed agreements with our office.
  • If Dr. Wexler believes your child needs to be seen in the office, you agree to all office visit associated fees (including another co-pay or coinsurance, if applicable).