Consent Form for Skype Consultations
By law Dr Siebecker may not diagnose or treat your condition without seeing you in person first. Specifically, she cannot order tests or prescriptions for you, diagnose you with SIBO or be your doctor.
Your primary care physician and/or other doctors should always be regarded as a primary source of information about diagnosis, treatment, prescription drugs, and medical conditions.
You agree to the following:
I have solicited Dr Siebecker for an educational consultation.
The information Dr Siebecker discusses is not medical advice, and should not be treated as such. The information provided is for informational, educational and entertainment purposes only. The information discussed is in no way intended to supplant the information provided by one's doctor(s).
I understand that no portion of any consultation is to be interpreted as diagnosis or treatment of anyone for anything.
Dr Siebecker is not:
Your primary care physician and/or other doctors should always be regarded as a primary source of information about diagnosis, treatment, prescription drugs, and medical conditions.
You agree to the following:
I have solicited Dr Siebecker for an educational consultation.
The information Dr Siebecker discusses is not medical advice, and should not be treated as such. The information provided is for informational, educational and entertainment purposes only. The information discussed is in no way intended to supplant the information provided by one's doctor(s).
I understand that no portion of any consultation is to be interpreted as diagnosis or treatment of anyone for anything.
Dr Siebecker is not:
- diagnosing or treating any disease or condition that I may have
- managing my health care
- providing medical services to me
- acting as my doctor and we have not entered into a doctor-patient relationship